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Active NPI 1891946240 Individual Practitioner Male Practitioner

Cedric Charles Wallace , PA-C

Physician Assistant • Freeport, NY

Professional Overview & Biography Verified Profile Summary

Cedric Wallace, PA-C is a registered healthcare professional specializing in Physician Assistant in Freeport, NY. Practice services are available at 20 COOLIDGE PL under active NPI credentials.

Frequently performed procedures and clinical services include emergency department visit with low level of medical decision making, emergency department visit for life threatening or functioning severity. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

20 Coolidge Pl

Freeport, NY 115202543

Telephone 5167795996

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Freeport, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.4 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
12 Specialists

Practicing in Freeport, NY (15701 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
72.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99283 Emergency department visit with low level of medical decision making
13 13 $215.00 $58.71
99285 Emergency department visit for life threatening or functioning severity
13 13 $590.00 $166.70

Medical Specialties & State Licenses

CMS Verified: 2021-04-02
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NY 012591

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 12, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location November 12, 2015

Registered at 20 COOLIDGE PL, FREEPORT, NY 115202543 (Tel: 5167795996)

📍
Updated Business Mailing Address November 12, 2015

Registered at 20 COOLIDGE PL, FREEPORT, NY 115202543 (Tel: 5167795996)

👤
Provider Name / Credentials Updated November 12, 2015

Recorded as CEDRIC WALLACE, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2015

Physician Assistant (License #012591 in NY)

🟢
Initial NPI Registration & Enumeration October 03, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891946240
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2008
Last Update: April 02, 2021
Sole Proprietor: Yes

Mailing Address

20 Coolidge Pl

Freeport, NY 115202543

Phone: 5167795996

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.