Brianna M Wallace, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00835000 Issued in NJ

Practice address

1945 Route 70 E Ste D
Cherry Hill, NJ 08003-2160

Phone

(856) 237-8045

Fax

(856) 237-8047

NPI assigned

Jan 24, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ, DE, MD3 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 3

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061
• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwallace323494@directvirtua.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christiana Care Health Services Inc

  • Hospitalist Physician
  • Newark, DE
  • NPI 1245474329
  Medicare reassignment Care Compare group NPD
• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group
• Union Hospital of Cecil County

  • Internal Medicine Physician
  • Elkton, MD
  • NPI 1124067848
  Medicare reassignment NPD
• Ultra Care Clinics LLC

  • Urgent Care Clinic/Center
  • Deptford, NJ
  • NPI 1285034108
  Medicare reassignment
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Hammonton, NJ
  • NPI 1396342507
  NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988

  Physician Assistant

  NPD
• Christiana Care Health Services Inc

  • Neurology Physician
  • Chadds Ford, PA
  • NPI 1881228484
  NPD
• Union Hospital of Cecil County

  • Psychiatry Physician
  • Elkton, MD
  • NPI 1689978751
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virtua - Memorial Hospital Burlington County, Inc.

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Willingboro Hospital Inc

  • General Acute Care Hospital
  • Willingboro, NJ
  • NPI 1053316844
  Care Compare affiliation
• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1184486235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-237-8045",
            "fax_number": "856-237-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 70 E STE D",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032160",
            "telephone_number": "856-237-8045",
            "fax_number": "856-237-8047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1132 Cooper St",
            "address_purpose": "LOCATION",
            "city": "Deptford",
            "state": "NJ",
            "postal_code": "080963014",
            "country_code": "US",
            "telephone_number": "856-848-8060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4755 OGLETOWN STANTON ROAD",
            "address_2": "SUITE 5A43",
            "address_purpose": "LOCATION",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-623-0188",
            "fax_number": "302-733-5640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "BRIANNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012199",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009759",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00835000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwallace323494@directvirtua.org",
            "affiliation": "N",
            "address_1": "1945 Route 70 E Ste D",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080032160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordana Hope Walka
• Ian Walker
• Robin Walker, DPT
• Ryan D Walker, M.D.
• Valerie D Walker
• Sarah Wallace
• April Waller-Lomax, PSY.D.
• Jeffrey Samuel Wallis, D.M.D.
• Michael Edward Walls, PT
• Gina Marie Walsh, MS, OTR/L

• Physician Assistant in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.