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

Jamie Wallace, NP

Individual provider Family Nurse Practitioner · NPI 1104608595

Jamie Wallace, NP is a Nurse Practitioner in Oswego, New York. Qualified in 2023, 3 years ago. Practices with Physician Care PC, a 77-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

110 W Utica St
Oswego, NY 13126-3047
Phone: (315) 668-1202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 353514 (NY)

Record details

NPI number1104608595
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 19, 2023
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024
Mailing address110 W Utica St, Oswego, NY 13126-3047

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Physician Care Pc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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