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

Mr. Shawn Michael Wallace, PA-C

Individual provider Physician Assistant · NPI 1124614706

Mr. Shawn Michael Wallace, PA-C is a Physician Assistant in Rio Rancho, New Mexico. Qualified in 2022, 4 years ago. Practices with Presbyterian Healthcare Services, a 1,375-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
4
Licensed in
NM
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2400 Unser Blvd SE Ste 08100
Rio Rancho, NM 87124
Phone: (505) 253-6100
Fax: (505) 253-6186
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA2022-0064 (NM)

Record details

NPI number1124614706
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 17, 2020
Last updated in NPPESOctober 28, 2022
Certification dateOctober 28, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Presbyterian Healthcare Services — 1375 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Rio Rancho