Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ryan Lee Wallace, MD

Individual provider Cardiovascular Disease Physician · NPI 1922663392

Dr. Ryan Lee Wallace, MD is a Cardiovascular Disease (Cardiology) in Boston, Massachusetts. Graduated from Virginia Commonwealth University, School of Medicine in 2019, 7 years ago. Licensed in Massachusetts.

Years since qualifying
7
Trained at
Virginia Commonwealth University, School of Medicine
Licensed in
MA
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

185 Pilgrim Rd
Boston, MA 02215-5324
Phone: (617) 667-8800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 1022399 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1922663392
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 1, 2019
Last updated in NPPESMay 1, 2026
Certification dateMay 1, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolVIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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