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MRS. TRACEE MARIE WALLACE PA-C
NPI 1811128010
Physician Assistant - Surgical in Washington, DC

Active since August 05, 2009PECOS Enrolled
5255 LOUGHBORO RD NW, WASHINGTON, DC 20016(202) 537-4000 Get Directions Write a Review

NPPES record last updated: May 1, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 1, 2023, Mar 28, 2017, Feb 20, 2017 (3 updates tracked since 2017).

About Mrs. Tracee Marie Wallace Pa-c NPPES

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

MRS. TRACEE MARIE WALLACE PA-C (NPI 1811128010) is an individual surgical provider in Washington, District Of Columbia, licensed in District Of Columbia (PA031280) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811128010
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMRS. TRACEE MARIE WALLACECredential: PA-C
Location Address5255 LOUGHBORO RD NWWashington, DC 20016-2633
Mailing Address10551 Hunters WayLaurel, MD 20723-5723 · (505) 573-1388
Phone(202) 537-4000
Sole ProprietorNo
Enumeration DateAugust 5, 2009
Last NPPES UpdateMay 1, 20233 updates tracked since enumeration
NPPES CertifiedMay 1, 2023
✔ NPI 1811128010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in DC · PA031280
5255 LOUGHBORO RD NW, Washington, DC 20016
Open in Google Maps ↗

Other Names 1

Former Name (1)Ms. Tracee Marie Hermanson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Tracee Marie 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.

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.

DANIEL RICHARD STAIRIKER CRNP
Nurse Practitioner
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 537-4000
HOWARD JIAHAU LI MD
Obstetrics & Gynecology
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 537-4000
MR. JOSEPH JOHN LIBRICZ JR. P.A.-C.
Physician Assistant (Surgical)
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (301) 589-3977
MICHAEL GOLDENHORN PHARMD
Pharmacist
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 537-4769
AARON CONARD
Radiology (Radiological Physics)
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (240) 366-7325
MONTY H. OPPENHEIM MD
Anesthesiology
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 243-2280
ANDREA L RICHARDSON MD PHD
Pathology (Cytopathology)
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 537-4455
DR. SHIVANI AHLAWAT MD
Radiology (Diagnostic Radiology)
5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
District of Columbia (202) 537-4686

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 Tracee Wallace's NPI number?

The NPI number for Tracee Wallace is 1811128010. It was assigned to this individual provider in the NPPES registry on August 5, 2009. The provider is also known as Ms. Tracee Marie Hermanson.

Where is Tracee Wallace located?

Tracee Wallace practices at 5255 Loughboro Rd NW, Washington, DC 20016. The listed phone number is (202) 537-4000.

What is Tracee Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Tracee Wallace enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tracee Wallace was last updated on May 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.