FABIOLA CORBETTE WALLACE MD - NPI 1932847282 - Family Medicine in New York, NY

Q: What is Fabiola Corbette Wallace's NPI number?

The NPI number for Fabiola Corbette Wallace is 1932847282. It was assigned to this individual provider in the NPPES registry on May 26, 2022.

Q: What is Fabiola Corbette Wallace's specialty?

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

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About Fabiola Corbette Wallace Md NPPES

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

FABIOLA CORBETTE WALLACE MD (NPI 1932847282) is an individual family medicine provider in New York, New York, licensed in New York (338132) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kingston, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1932847282

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameFABIOLA CORBETTE WALLACECredential: MD

Location Address1790 BROADWAY STE 1802New York, NY 10019-1471

Mailing Address1 Embarcadero Ctr Ste 1900San Francisco, CA 94111-3723 · (415) 658-6791 · Fax (845) 338-0307

Phone(212) 530-0624

Fax(415) 252-7176

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 26, 2022

Last NPPES UpdateNovember 7, 20252 updates tracked since enumeration

NPPES CertifiedNovember 7, 2025

✔ NPI 1932847282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 338132

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1790 BROADWAY STE 1802, New York, NY 10019

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Secondary Practice Location 1

Location 11 Family Practice DrKingston, NY 12401-6449 · Phone (845) 338-6400 · Fax (845) 339-7288

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fabiola Corbette Wallace Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264923176

PECOS Enrollment IDI20251118002295

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 10019 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 11

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

ELAINA FRANTELLIZZI NP

Nurse Practitioner