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

Gregory Wallace, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558701250

Gregory Wallace, DO is a Family Practice in Fort Drum, New York. Graduated from Philadelphia College of Osteopathic Medicine in 2013, 13 years ago. Practices with Advocare, LLC, a 385-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
13
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
IN
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

11050 Mount Belvedere Blvd
Fort Drum, NY 13602
Phone: (315) 772-5662
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2817 Reilly St, Fort Bragg, NC 28310-7324 — (910) 907-8922

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 02004547A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1558701250
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 27, 2013
Last updated in NPPESJuly 27, 2018
Mailing address11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2013 (13 years in practice)
Group practice Advocare, Llc — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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