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

Matthew Alexander Wallace, PA

Individual provider Medical Physician Assistant · NPI 1427321041

Matthew Alexander Wallace, PA is a Medical Physician Assistant in New York, New York. Works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2012
Specialties on file
2
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

489 5th Ave Fl 3
New York, NY 10017-6145
Phone: (888) 663-6331
Fax: (415) 252-7176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5047 Suncatcher Dr, Wesley Chapel, FL 33545-3234 — (616) 318-9649

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 035105 (NY)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1427321041
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 13, 2012
Last updated in NPPESMarch 18, 2026
Certification dateMarch 18, 2026

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