MARISSA LEANNE WALLACE NP NPI 1689932360

NPI Information

  • NPI: 1689932360
  • Provider Name: MARISSA LEANNE WALLACE, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3078 ROUTE 9W STE 100
    NEW WINDSOR, NY
    ZIP 12553
  • Phone: (845) 561-3310

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NPI Details

Marissa Leanne Wallace, NP is an adult health nurse practitioner in New Windsor, NY with 9 years of experience. Marissa Leanne Wallace, NP NPI is 1689932360. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3078 ROUTE 9W STE 100
NEW WINDSOR, NY
ZIP 12553-751
Phone: (845) 561-3310
Fax: (845) 561-8728

The NPI 1689932360 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Hospital observation care on day of discharge (HCPCS:99217)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Follow-up observation care per day, typically 25 minutes (HCPCS:99225)

The enumeration date for this NPI number is 5/1/2012 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse653689-1NEW YORKNo
2363LA2200XNurse PractitionerAdult HealthF308236NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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