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

Lydia Wallace

Individual provider Emergency Medicine Physician · NPI 1417344581

Lydia Wallace is an Emergency Medicine in Brockton, Massachusetts. Graduated from Tufts University School of Medicine in 2015, 11 years ago. Practices with Emergency Staffing Solutions Inc, a 58-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Massachusetts and New Mexico.

Years since qualifying
11
Trained at
Tufts University School of Medicine
Licensed in
MA, NM
In the registry since
2015
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

235 N Pearl St
Brockton, MA 02301-1794
Phone: (617) 414-5405
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (2)

  • 145 Harrison Ave, Boston, MA 02111-1802 — (161) 763-6656
  • 101 Hospital Loop Ne, Albuquerque, NM 87109-2129 — (615) 928-6268

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 1024211 (MA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence MD2019-0840 (NM)

Record details

NPI number1417344581
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 16, 2015
Last updated in NPPESAugust 2, 2025
Certification dateAugust 2, 2025
Mailing address960 Massachusetts Ave Ste 2, Boston, MA 02118-2690

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Emergency Staffing Solutions Inc — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Brockton