Individual provider Active NPI

Duncan Ronald Wallace, PA-C

  • Physician Assistant
  • Enola, PA
National Provider Identifier
1376430900
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA007285 Issued in PA
Practice address
325 N Enola Rd
Enola, PA 17025-2123
Phone
(717) 732-4911
Fax
(717) 409-8948
NPI assigned
Jun 18, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X MA066672 PA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X OA007285 PA Primary

Addresses

Primary practice location

325 N Enola Rd
Enola, PA 17025-2123

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other practice location 1

210 Forge Rd Ste 2
Boiling Springs, PA 17007-9787
Phone (717) 254-6109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250717001604 PA Practitioner - Physician Assistant 1557876513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

1 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-5889

210 Forge Rd
Suite 2
Boiling Springs, PA 17007-9787
Phone (717) 254-6109

325 N Enola Rd
Enola, PA 17025-2123
Phone (717) 412-7500

Hospital & facility affiliations

  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Multi-Specialty CurrentSince Jul 8, 2025 Accepting new patients

Locations

210 Forge Rd
#2
Boiling Springs, PA 17007
Phone (717) 249-8300

325 N Enola Rd
Enola, PA 17025
Phone (717) 732-4911

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

Interoperability endpoints

  • Direct secure messaging: duncanwallacepa@fpc.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1376430900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N ENOLA RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170252123",
            "telephone_number": "717-732-4911",
            "fax_number": "717-409-8948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Forge Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "PA",
            "postal_code": "170079787",
            "country_code": "US",
            "telephone_number": "717-254-6109",
            "fax_number": "717-701-8522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DUNCAN",
        "middle_name": "RONALD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066672",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA007285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enola, PA

Sources for this page

Verify at the official NPI Registry.