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

Kelleyayn Wallace, PA

Individual provider Physician Assistant · NPI 1831290717

Kelleyayn Wallace, PA is a Physician Assistant in Rochester, New York. Qualified in 2006, 20 years ago. Practices with Texas Digestive Disease Consultants, PLLC, a 615-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
20
Licensed in
NY
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2080 Clinton Ave S
Rochester, NY 14618
Phone: (585) 271-2800
Fax: (585) 271-0375
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 011509 (NY)

Record details

NPI number1831290717
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 26, 2006
Last updated in NPPESDecember 9, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Texas Digestive Disease Consultants, Pllc — 615 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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