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

Maura Kathleen Wallace, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1881459667

Maura Kathleen Wallace, PHYSICIANASSISTANT is a Physician Assistant in Worthington, Ohio. Qualified in 2023, 3 years ago. Practices with Central Ohio Primary Care Physicians, Inc, a 487-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2024

Practice location Address checks out

874 Proprietors Rd
Worthington, OH 43085-3152
Phone: (614) 885-9405
Fax: (614) 885-9481
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 50.008630 (OH)

Record details

NPI number1881459667
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedFebruary 20, 2024
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Central Ohio Primary Care Physicians, Inc. — 487 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare