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

MS. Kyana Wallace, PA-C

Individual provider Physician Assistant · NPI 1558611483

MS. Kyana Wallace, PA-C is a Physician Assistant in New York, New York. Qualified in 2019, 7 years ago. Practices with North Shore Lij Urgent Care PC, a 395-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

75 Broad St
New York, NY 10004-2415 Not confirmed with CMS for 14 years — call before visiting
Phone: (877) 456-0369
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 051928-1 (NY)

Record details

NPI number1558611483
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 18, 2012
Last updated in NPPESSeptember 20, 2012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice North Shore Lij Urgent Care Pc — 395 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients213
Services billed 225 a service is one billed item, such as a visit, a test or a procedure
Average patient age68

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at North Shore Lij Urgent Care PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 395 clinicians in the practice; 12 are shown here.

Other providers in New York