LAURIE J WALLACE RPA-C
NPI 1326261579
Physician Assistant in Miller Place, NY

Active since April 10, 2007PECOS EnrolledAccepts Medicare Assignment
765 ROUTE 25A STE 6, MILLER PLACE, NY 11764(631) 320-3200 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Laurie J Wallace Rpa-c NPPES

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

LAURIE J WALLACE RPA-C (NPI 1326261579) is an individual physician assistant in Miller Place, New York, licensed in New York (006630-1) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1326261579
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLAURIE J WALLACECredential: RPA-C
Location Address765 ROUTE 25A STE 6Miller Place, NY 11764-2649
Mailing Address1 E Roe BlvdPatchogue, NY 11772-2631 · (631) 475-3900
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateApril 10, 2007
Last NPPES UpdateNovember 10, 2021
NPPES CertifiedNovember 10, 2021
NPI 1326261579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NY · 006630-1
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
765 ROUTE 25A STE 6, Miller Place, NY 11764

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Laurie J Wallace Rpa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133436934
PECOS Enrollment IDI20150910002259
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 25

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
480 services141 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
226 services106 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
132 services54 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
113 services33 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
97 services53 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
96 services43 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

John T Mather Memorial Hospital Of Port Jefferson

Acute Care Hospitals · Port Jefferson, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330185
Location75 North Country RoadPort Jefferson, NY 11777 · Suffolk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11764 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers12 claims41 services$6.07 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner
765 ROUTE 25A STE 6
MILLER PLACE, NY 11764
Family Medicine
765 ROUTE 25A STE 6
MILLER PLACE, NY 11764

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 Laurie Wallace's NPI number?

The NPI number for Laurie Wallace is 1326261579. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Laurie Wallace located?

Laurie Wallace practices at 765 Route 25A Ste 6, Miller Place, NY 11764. The listed phone number is (631) 320-3200.

What is Laurie Wallace's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Laurie Wallace enrolled in Medicare?

Yes. Laurie Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Laurie Wallace affiliated with any hospitals?

According to CMS data, Laurie Wallace is affiliated with John T Mather Memorial Hospital Of Port Jefferson.

When was this NPI record last updated?

The NPPES record for Laurie Wallace was last updated on November 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.