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

Moira Petirs Wallace, MD

Individual provider Emergency Medicine Physician · NPI 1053549212

Moira Petirs Wallace, MD is an Emergency Medicine in Jacksonville, Florida. Graduated from Albert Einstein College of Medicine of Yeshiva University in 2008, 18 years ago. Practices with Paragon Emergency Services LLC, a 406-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Florida.

Years since qualifying
18
Trained at
Albert Einstein College of Medicine of Yeshiva University
Licensed in
CA, FL
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone: (904) 702-6111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1555 Soquel Dr, Santa Cruz, CA 95065-1705 — (831) 462-7501

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence ME133941 (FL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence A120516 (CA)

Record details

NPI number1053549212
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 26, 2009
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Graduated 2008 (18 years in practice)
Group practice Paragon Emergency Services Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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