Nichole Wallace, PA
Nichole Wallace, PA is a Medical Physician Assistant in Brooklyn, NY, registered under NPI 1114379708.
Getting there
The practice address on file is 760 BROADWAY, Brooklyn, NY 11206. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Practitioner - Physician Assistant
- PAC ID
- 0941598932
Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Medical covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1114379708 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jul 6, 2016 |
| Last updated | Aug 18, 2023 |
| Status | Active |
| Sole proprietor | No |
| Credential | PA |
| Practice address |
760 BROADWAY Brooklyn, NY 11206 (718) 312-2312 |
| Mailing address |
833 PENFIELD ST Bronx, NY 10470 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 1 | 4 | 3 | 7 | 9 | 7 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 2 | 4 | 6 | 7 | 9 | 7 | 0 |
Sum = 62 · next multiple of 10 = 70 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.