Sara Grace Wallin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

600 N Hiatus Rd
Pembroke Pines, FL 33026-5207

Phone

(954) 526-6378

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: sara.wallin@398008301912068.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1053903294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-526-6378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 N Main Ave",
            "address_purpose": "LOCATION",
            "city": "Lovington",
            "state": "NM",
            "postal_code": "882602813",
            "country_code": "US",
            "telephone_number": "575-396-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "SARA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9114066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgw26@drexel.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1601 Cherry St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191021320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lasonya Walker, ARNP
• Ramona Lynn Walker
• Donna C. Wallace, PHARMD
• Karen Wallace
• Elaine Wallen
• Azel Wallock
• Walnut Creek Medical Center, Inc
• Michael Francis Walsh II, MD
• Demetrius Walton
• Stephen H Wander, D.D.S.

• Physician Assistant in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.