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CONNIE SUE WALLACE PA-C
NPI 1619179132
Physician Assistant in Huntersville, NC

Active since June 05, 2007PECOS Enrolled
10030 GILEAD RD STE 201, HUNTERSVILLE, NC 28078(704) 887-4530(704) 887-4531 Get Directions Write a Review

NPPES record last updated: August 23, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 23, 2022, Jun 16, 2021, Oct 28, 2020 and 1 more (4 updates tracked since 2018).

About Connie Sue Wallace Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNIE SUE WALLACE PA-C (NPI 1619179132) is an individual physician assistant in Huntersville, North Carolina, licensed in North Carolina (102472) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Charlotte.

NPPES Registry Identity

NPI1619179132
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCONNIE SUE WALLACECredential: PA-C
Location Address10030 GILEAD RD STE 201Huntersville, NC 28078-7545
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-5043 · Fax (704) 384-8895
Phone(704) 887-4530
Fax(704) 887-4531
Sole ProprietorNo
Enumeration DateJune 5, 2007
Last NPPES UpdateAugust 23, 20224 updates tracked since enumeration
NPPES CertifiedAugust 23, 2022
✔ NPI 1619179132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 102472
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 102472 (NC)
10030 GILEAD RD STE 201, Huntersville, NC 28078
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Secondary Practice Location 1

Location 1125 Queens Rd Ste 330Charlotte, NC 28204-3215 · Phone (704) 384-5043 · Fax (704) 384-8895

Other Identifiers 3

Other2747736ENC · Medicare Ptan
Medicaid8101076NC
Other159XJNC · Bcbs

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connie Sue Wallace Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
19 services17 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
16 services12 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
16 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28078 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
91%96 patients4/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 21 patients
100%22 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
95%152 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
39%175 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
7%139 patients1/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
84%81 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STORMI GALE CPP
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
10030 GILEAD RD STE 201
HUNTERSVILLE, NC 28078
Mecklenburg County (704) 887-4530
REGINA V STEFIC P.A.
Physician Assistant
10030 GILEAD RD STE 201
HUNTERSVILLE, NC 28078
Mecklenburg County (704) 887-4530
JOSEPH LAKE TRASK SR. MD
Internal Medicine (Cardiovascular Disease)
10030 GILEAD RD STE 201
HUNTERSVILLE, NC 28078
Mecklenburg County (704) 887-4530

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connie Wallace's NPI number?

The NPI number for Connie Wallace is 1619179132. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Connie Wallace located?

Connie Wallace practices at 10030 Gilead Rd Ste 201, Huntersville, NC 28078. The listed phone number is (704) 887-4530.

What is Connie Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Connie Wallace enrolled in Medicare?

Yes. Connie Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Connie Wallace was last updated on August 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.