DR. RYAN MYLES WALLACE
NPI 1548695075
Psychiatry & Neurology - Psychiatry in Anchorage, AK

Q: What is Ryan Wallace's NPI number?

The NPI number for Ryan Wallace is 1548695075. It was assigned to this individual provider in the NPPES registry on September 3, 2013.

Q: What is Ryan Wallace's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Wallace was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since September 03, 2013PECOS EnrolledAccepts Medicare Assignment

3760 PIPER ST STE 1108, ANCHORAGE, AK 99508(907) 212-6900(907) 212-6936 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2025, Mar 4, 2021, Jul 9, 2018 and 2 more (5 updates tracked since 2018).

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About Dr. Ryan Myles Wallace NPPES

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

DR. RYAN MYLES WALLACE (NPI 1548695075) is an individual psychiatry provider in Anchorage, Alaska, licensed in Alaska (158491) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of University Of Washington School Of Medicine (2014).

NPPES Registry Identity

NPI1548695075

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameDR. RYAN MYLES WALLACE

Location Address3760 PIPER ST STE 1108Anchorage, AK 99508-4683

Mailing AddressPo Box 31001-4162Pasadena, CA 91110-4162 · (866) 747-2455

Phone(907) 212-6900

Fax(907) 212-6936

Sole ProprietorNo

Medical School CMSUniversity Of Washington School Of MedicineGraduated 2014

Enumeration DateSeptember 3, 2013

Last NPPES UpdateDecember 3, 20255 updates tracked since enumeration

NPPES CertifiedDecember 3, 2025

✔ NPI 1548695075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in AK · 158491✔ Licensed in CT · 55490

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedPreventive Medicine · Addiction MedicineTaxonomy 2083A0300X · License 158491 (AK)

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 55490 (CT)

3760 PIPER ST STE 1108, Anchorage, AK 99508

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Secondary Practice Locations 3

Location 11201 E 36th AveAnchorage, AK 99508-4372 · Phone (907) 562-9229 · Fax (907) 562-1603

Location 255 Lock StNew Haven, CT 06511 · Phone (203) 432-0290

Location 3365 Montauk AveNew London, CT 06320-4700 · Phone (860) 442-0711

Other Identifiers 6

Medicaid1709157AK

Medicaid008056168CT

Medicaid500000315CT

Medicaid008076123CT

Medicaid004082286CT

Medicaid008022626CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

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

Dr. Ryan Myles Wallace 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 ID2769703552

PECOS Enrollment IDI20200917000602

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99508 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

$222.64 typical visit price

range $71.33 – $222.64

Typical copayment $55.66 (range $17.83 – $55.66)

Most-billed visit code 99205

Established Patient

$90.40 typical visit price

range $21.84 – $181.48

Typical copayment $22.60 (range $5.46 – $45.37)

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.

Other Providers at the Same Location NPPES 20

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

JASMINE PORTER MS, CDC I, MAC, LPC

Counselor (Professional)