Cedric Wallace, PA-C
NPI 1891946240 · Physician Assistant · Freeport, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Cedric Wallace, PA-C is a Physician Assistant provider in Freeport, NY (NPI 1891946240).
Provider details
- NPI number
- 1891946240
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- 012591 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-10-03
- Last updated
- 2021-04-02
- Certified
- 2021-04-02
Frequently asked questions
- What is Cedric Wallace's NPI number?
- Cedric Wallace's National Provider Identifier (NPI) is 1891946240, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Cedric Wallace's specialty?
- Cedric Wallace is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Cedric Wallace located?
- Cedric Wallace's practice location on file with NPPES is 20 Coolidge Pl, Freeport, NY 11520-2543.
- What is Cedric Wallace's phone number?
- The practice phone number listed in the NPPES registry for Cedric Wallace is (516) 779-5996.
- Does Cedric Wallace accept Medicare?
- Cedric Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Cedric Wallace's NPI active?
- Yes — Cedric Wallace's NPI (1891946240) is active in the NPPES registry as of the last update on 2021-04-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.