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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

STEPHANIE WALLMAN D.O.
NPI 1134519580
Family Medicine in New York, NY

Active since January 23, 2015Opted out of Medicare · through Jan 1, 2027
535 5TH AVE RM 603, NEW YORK, NY 10017(646) 200-5750 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2026, Jul 21, 2022, Sep 23, 2021 and 1 more (4 updates tracked since 2018).

About Stephanie Wallman D.o. NPPES

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

STEPHANIE WALLMAN D.O. (NPI 1134519580) is an individual family medicine provider in New York, New York, licensed in New York (288963) and active in the NPI registry since January 2015. She has opted out of Medicare through January 1, 2027 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1134519580
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSTEPHANIE WALLMANCredential: D.O.
Location Address535 5TH AVE RM 603New York, NY 10017-8009
Mailing Address535 5th Ave Rm 603New York, NY 10017-8009 · (646) 200-5750
Phone(646) 200-5750
Sole ProprietorNo
Enumeration DateJanuary 23, 2015
Last NPPES UpdateJuly 29, 20264 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1134519580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 288963
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
535 5TH AVE RM 603, New York, NY 10017
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Secondary Practice Locations 2

Location 132 Lawrence Ave Ste 206Smithtown, NY 11787-3605 · Phone (631) 265-1763
Location 2116 E 63rd St Apt 1ANew York, NY 10065-7265 · Phone (646) 200-5750

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Stephanie Wallman D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2019 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2019
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10017 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AVENUE MEDICAL WELLNESS PC
Family Medicine
535 5TH AVE RM 603
NEW YORK, NY 10017
New York County (310) 614-3697
CINDY MARIA RESTREPO RN
Registered Nurse
535 5TH AVE RM 603
NEW YORK, NY 10017
New York County (646) 200-5750
SHERA RAISEN M.D.
Family Medicine
535 5TH AVE RM 603
NEW YORK, NY 10017
New York County (646) 200-5750
AVENUE MEDICAL WELLNESS PC
Family Medicine
535 5TH AVE RM 603
NEW YORK, NY 10017
New York County (646) 200-5750

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 Stephanie Wallman's NPI number?

The NPI number for Stephanie Wallman is 1134519580. It was assigned to this individual provider in the NPPES registry on January 23, 2015.

Where is Stephanie Wallman located?

Stephanie Wallman practices at 535 5th Ave Rm 603, New York, NY 10017. The listed phone number is (646) 200-5750.

What is Stephanie Wallman's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Stephanie Wallman enrolled in Medicare?

No. Stephanie Wallman has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Stephanie Wallman was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days 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.