Alexandra Baltazar Wallace, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

507 Kimberton Rd
Phoenixville, PA 19460-4745

Phone

(610) 243-9117

NPI assigned

Jun 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monarch Medical, LLCGroup PAC ID 6204057458, 7 clinicians

Tri-County Hospitalists LLCGroup PAC ID 4385872290, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Monarch Medical, LLC

  • Urgent Care Clinic/Center
  • Phoenixville, PA
  • NPI 1801206305
  Medicare reassignment Care Compare group
• Tri-County Hospitalists, LLC

  • Internal Medicine Physician
  • Phoenixville, PA
  • NPI 1730518564
  Medicare reassignment Care Compare group
• Tri-County Urgent Care LLC

  • Urgent Care Clinic/Center
  • Phoenixville, PA
  • NPI 1972399376
  Medicare reassignment

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748649600000",
    "number": "1740966829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 KIMBERTON RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604745",
            "telephone_number": "610-243-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 KIMBERTON RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194604745",
            "telephone_number": "610-243-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALEXANDRA",
        "middle_name": "BALTAZAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2025-05-31",
        "certification_date": "2025-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leyla Wade, MD
• Jane Jelagat Wafula
• Robert Sammy Wafula
• Walgreen Co
• Christopher Jones Walinski, DDS
• Jacqueline A. Walsh, CRNP
• Le Wang, MD
• John Francis Warner III, LAT, ATC
• Emily Warrick
• Thomas W Waugh

• Physician Assistant in Phoenixville, PA
• Providers in Phoenixville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2025; 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.