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

Ryan Wallace, NP

Individual provider Registered Nurse · NPI 1689389868

Ryan Wallace, NP is a Nurse Practitioner in Poughkeepsie, New York. Qualified in 2021, 5 years ago. Practices with Nuvance Health Medical Practice PC, a 575-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Connecticut and New York.

Years since qualifying
5
Licensed in
CT, NY
In the registry since
2023
Specialties on file
4
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

45 Reade Pl
Poughkeepsie, NY 12601-3947
Phone: (917) 504-6635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 838 Fair St, Carmel, NY 10512-3085 — (845) 878-4111
  • 6136 170th St Apt M4, Fresh Meadows, NY 11365-1957 — (845) 297-3913
  • 300 Grant Ave, Lake Katrine, NY 12449-5340 — (845) 366-3500

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 310895 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 170263 (CT)
Registered Nurse Taxonomy 163W00000X · Licence 639923 (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence 10962 (CT)

Record details

NPI number1689389868
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 23, 2023
Last updated in NPPESJune 16, 2025
Certification dateJune 16, 2025
Mailing address6136 170th St Apt M4, Fresh Meadows, NY 11365-1957

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Nuvance Health Medical Practice Pc — 575 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Poughkeepsie