TONIA WALLACE PMHNP-BC
NPI 1700531498
Nurse Practitioner - Psychiatric/Mental Health in Glendale, AZ

Q: What is Tonia Wallace's NPI number?

The NPI number for Tonia Wallace is 1700531498. It was assigned to this individual provider in the NPPES registry on February 21, 2022.

Q: What is Tonia Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Tonia Wallace was last updated on November 20, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 21, 2022PECOS Enrolled

6751 N SUNSET BLVD STE 320, GLENDALE, AZ 85305(480) 516-8037 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2025, Feb 21, 2022 (2 updates tracked since 2022).

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About Tonia Wallace Pmhnp-bc NPPES

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

TONIA WALLACE PMHNP-BC (NPI 1700531498) is an individual psychiatric/mental health provider in Glendale, Arizona, licensed in North Carolina (5020892) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1700531498

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameTONIA WALLACECredential: PMHNP-BC

Location Address6751 N SUNSET BLVD STE 320Glendale, AZ 85305-3155

Mailing Address15652 W Durango StGoodyear, AZ 85338-3370 · (708) 829-1520

Phone(480) 516-8037

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 21, 2022

Last NPPES UpdateNovember 20, 20252 updates tracked since enumeration

NPPES CertifiedNovember 20, 2025

✔ NPI 1700531498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in NC · 5020892✔ Licensed in AZ · 270985

6751 N SUNSET BLVD STE 320, Glendale, AZ 85305

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, BlueCross BlueShield of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tonia Wallace Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911381496

PECOS Enrollment IDI20240402001158, I20241211003518

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85305 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

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

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