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

Ryan Jeffrey Wallace, PA-C

Individual provider Surgical Physician Assistant · NPI 1285528422

Ryan Jeffrey Wallace, PA-C is a Physician Assistant in Erie, Pennsylvania. Qualified in 2025, 1 year ago. Practices with Millcreek Community Hospital, a 67-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
1
Licensed in
PA
In the registry since
2025
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

5401 Peach St Ste 3300
Erie, PA 16509-2601
Phone: (814) 868-7840
Show map & directions

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

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1226276 (PA)

Record details

NPI number1285528422
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 4, 2025
Last updated in NPPESJune 4, 2025
Certification dateJune 4, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Millcreek Community Hospital — 67 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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