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

Wallace E Johnson, MD

Individual provider Internal Medicine Physician · NPI 1902833619

Wallace E Johnson, MD is an Internal Medicine in Fairport, New York. Graduated from State University of New York at Buffalo School of Medicine in 1993, 33 years ago. Practices with University of Rochester, a 962-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
33
Trained at
State University of New York at Buffalo School of Medicine
Licensed in
NY
In the registry since
2006
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

800 Ayrault Rd Ste 200
Fairport, NY 14450-8941
Phone: (585) 602-2300
Fax: (585) 425-2750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 200706 (NY)

Record details

NPI number1902833619
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 27, 2006
Last updated in NPPESJuly 3, 2023
Mailing address800 Ayrault Rd Ste 200, Fairport, NY 14450-8941

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice University Of Rochester — 962 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Fairport