Doctor profile · Federal record
Dr. Nichole Wallace, PA
Medical Physician Assistant (CMS: Physician Assistant) · Brooklyn, NY
- NPI 1114379708
- Accepts Medicare
- 3 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
760 Broadway
Brooklyn, NY 112065317
(718) 312-2312 - Additional location
-
10959 W Colonial Dr, Units 6&8
Ocoee, FL 34761
(407) 554-4591 - Mailing address
-
833 Penfield St
Bronx, NY 104701322
Credentials & registration
- NPI registered
- July 2016 — 10 yrs on file
- Profile last updated
- August 18, 2023
- Year of graduation
- 2023 — 3 yrs since
- Specialty taxonomy
- 363AM0700X — NUCC code
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1114379708. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$18
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Emd Serono, INC. | 1 | $17.64 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
2,164
Patients
1,028
Total drug cost
$355,091
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Oxycodone-Acetaminophen (Oxycodone Hcl/Acetaminophen) | Brand | 704 | 288 | $17,026 |
| Endocet (Oxycodone Hcl/Acetaminophen) | Brand | 248 | 102 | $7,392 |
| Diclofenac Sodium | Generic | 174 | 75 | $100,146 |
| Gabapentin | Generic | 173 | 89 | $2,738 |
| Naloxone Hcl | Generic | 155 | 153 | $13,307 |
| Meloxicam | Generic | 112 | 55 | $648 |
| Lidocaine | Generic | 104 | 49 | $24,073 |
| Methocarbamol | Generic | 104 | 63 | $1,421 |
| Oxycodone Hcl | Generic | 95 | 34 | $1,634 |
| Baclofen | Generic | 83 | 36 | $1,651 |
Frequently asked questions
What is Dr. Nichole Wallace's medical specialty?
Dr. Nichole Wallace practices Medical Physician Assistant in Brooklyn, NY.
Where does Dr. Nichole Wallace practice?
Dr. Nichole Wallace practices at 760 Broadway, Brooklyn, NY 112065317. Office phone: 7183122312.
What is Dr. Nichole Wallace's NPI?
Dr. Nichole Wallace's National Provider Identifier (NPI) is 1114379708, issued by NPPES.
Does Dr. Nichole Wallace accept Medicare assignment?
Yes. Dr. Nichole Wallace accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.