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

Laurie J Wallace, RPA-C

Individual provider Physician Assistant · NPI 1326261579

Laurie J Wallace, RPA-C is a Physician Assistant in Miller Place, New York. Qualified in 1998, 28 years ago. Practices with Caremed Primary and Urgent Care PC, a 21-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
28
Licensed in
NY
In the registry since
2007

Practice location Address checks out

765 Route 25A Ste 6
Miller Place, NY 11764-2649
Phone: (631) 320-3200
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 006630-1 (NY)

Record details

NPI number1326261579
Entity typeIndividual (Type 1)
GenderFemale
Credentials RPA-C
Sole proprietorYes
NPI enumeratedApril 10, 2007
Last updated in NPPESNovember 10, 2021
Certification dateNovember 10, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Caremed Primary And Urgent Care Pc — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Miller Place