Ryan Wallace, NP in Poughkeepsie, NY - Medicare Nurse Practitioner

Ryan Wallace, NP is a medicare enrolled "Nurse Practitioner - Adult Health" in Poughkeepsie, New York. His current practice location is 45 Reade Pl, Poughkeepsie, New York. You can reach out to his office (for appointments etc.) via phone at (917) 504-6635.

Ryan Wallace is licensed to practice in New York (license number 310895) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689389868.

Contact Information

	Ryan Wallace, NP
	45 Reade Pl, Poughkeepsie, NY 12601-3947
	(917) 504-6635
	Not Available

Map and Direction

Provider's Profile

Full Name	Ryan Wallace
Gender	Male
Speciality	Nurse Practitioner - Adult Health
Location	45 Reade Pl, Poughkeepsie, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689389868
Provider Enumeration Date: 01/23/2023
Last Update Date: 06/16/2025

Medicare PECOS Information:

PECOS PAC ID: 2466416813
Enrollment ID: I20230419001284

Medical Identifiers

Medical identifiers for Ryan Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689389868	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	170263 (Connecticut)	Secondary
163W00000X	Registered Nurse	639923 (New York)	Secondary
363L00000X	Nurse Practitioner	10962 (Connecticut)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	310895 (New York)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ryan Wallace allows following entities to bill medicare on his behalf.

Entity Name	Nuvance Health Medical Practice, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437358033 PECOS PAC ID: 1658468442 Enrollment ID: O20071025000436

Entity Name	Peyman Younesi Md Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891053328 PECOS PAC ID: 4981860202 Enrollment ID: O20120731000499

Entity Name	Py Medical Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043081524 PECOS PAC ID: 2961840319 Enrollment ID: O20240403003443

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ryan Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ryan Wallace, NP 6136 170th St Apt M4, Fresh Meadows, NY 11365-1957 Ph: (845) 297-3913	Ryan Wallace, NP 45 Reade Pl, Poughkeepsie, NY 12601-3947 Ph: (917) 504-6635

Reviews and Comments

Nurse Practitioner Nurses in Poughkeepsie, NY

Miss Laura Robinson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 Fulton Ave, Poughkeepsie, NY 12603 Phone: 845-473-8996 Fax: 845-797-5054
Christine Wilson, AGACNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 45 Reade Pl, Poughkeepsie, NY 12601 Phone: 845-454-8500
Olivia Maamle Obuabang, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12 Knightsbridge Unit E, Poughkeepsie, NY 12603 Phone: 646-245-9527
Dorothy A Gioia, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 696 Dutchess Tpke Ste 11, Poughkeepsie, NY 12603 Phone: 845-454-8200 Fax: 845-343-3295
Ms. Lisa Gruenhut Gold, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Bushwick Rd Ste B, Poughkeepsie, NY 12603 Phone: 845-654-0506 Fax: 845-842-1361
Matthew John Pernice, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 696 Dutchess Tpke, Poughkeepsie, NY 12603 Phone: 845-204-9260
Margaret Speedling, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 488 Freedom Plains Rd, Poughkeepsie, NY 12603 Phone: 845-452-5151

Ryan Wallace, NP - Medicare Nurse Practitioner in Poughkeepsie, NY