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MIKAYLA WALLACE
NPI 1962162875
Physician Assistant in Jersey City, NJ

Active since December 20, 2021PECOS Enrolled
355 GRAND ST, JERSEY CITY, NJ 07302(201) 915-2000 Get Directions Write a Review

NPPES record last updated: July 30, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 30, 2024, Jul 7, 2024, Dec 20, 2021 (3 updates tracked since 2021).

About Mikayla Wallace NPPES

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

MIKAYLA WALLACE (NPI 1962162875) is an individual physician assistant in Jersey City, New Jersey, licensed in New Jersey (25MP00684600) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962162875
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMIKAYLA WALLACE
Location Address355 GRAND STJersey City, NJ 07302-4321
Mailing Address113 Hofstra University Rm 231Hempstead, NY 11549-1925
Phone(201) 915-2000
Sole ProprietorYes
Enumeration DateDecember 20, 2021
Last NPPES UpdateJuly 30, 20243 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1962162875 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 NJ · 25MP00684600
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.
355 GRAND ST, Jersey City, NJ 07302
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 07302 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
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
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.

JERSEY CITY CRITICAL CARE ASSOCIATES
Specialist
355 GRAND ST, JERSEY CITY MEDICAL CENTER
JERSEY CITY, NJ 07302
Hudson County (908) 806-8224
SHERIDAN ANESTHESIA SERVICES OF NEW JERSEY PC
Anesthesiology
355 GRAND ST
JERSEY CITY, NJ 07302
Hudson County (201) 915-2000
SAIRA SHAH MD
Internal Medicine
355 GRAND ST, MEDICINE DEPT,3RD FLOOR
JERSEY CITY, NJ 07302
Hudson County (201) 915-2000
SUSAN E. O'BRIEN DO
Emergency Medicine
355 GRAND ST, JERSEY CITY MEDICAL CENTER
JERSEY CITY, NJ 07302
Hudson County (201) 915-2000
DR. JARED SAUL KROK M.D.
Internal Medicine
355 GRAND ST
JERSEY CITY, NJ 07302
Hudson County (201) 915-2431
ANIELLO SEMIOLI LSW
Social Worker
355 GRAND ST
JERSEY CITY, NJ 07302
Hudson County (201) 492-1296
SUMEETA BHOGAL MD
Student in an Organized Health Care Education/Training Program
355 GRAND ST
JERSEY CITY, NJ 07302
Hudson County (201) 915-2000
LIBERTY EMERGENCY MEDICAL ASSOCIATES LLC
Emergency Medicine
355 GRAND ST, JERSEY CITY MEDICAL CENTER ( EMERGENCY DEPARTMENT)
JERSEY CITY, NJ 07302
Hudson County (469) 401-2386

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 Mikayla Wallace's NPI number?

The NPI number for Mikayla Wallace is 1962162875. It was assigned to this individual provider in the NPPES registry on December 20, 2021.

Where is Mikayla Wallace located?

Mikayla Wallace practices at 355 Grand St, Jersey City, NJ 07302. The listed phone number is (201) 915-2000.

What is Mikayla Wallace's specialty?

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

Is Mikayla Wallace enrolled in Medicare?

Yes. Mikayla Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mikayla Wallace was last updated on July 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.