LATOYA M. WALLACE (PA) – Physician Assistant, NPI 1073764114

LATOYA M. WALLACE (PA) is a healthcare provider. based in Pensacola, Florida. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 4254 (AZ). The NPI Number for LATOYA M. WALLACE (PA) is 1073764114

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
LATOYA M. WALLACE (PA)
NPI
1073764114
Phone
(850) 469-7771
Address
1717 N E St
Enumeration Date
7 October 2008
Last Update Date
15 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2008 (18 years ago)
PAC ID
5890853303
Group Practice PAC ID
9638215734
Professional Enrollment ID
I20170225000237
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience77
Completeness75
Years active:17State licenses:2Digital endpointsOther names

Provider Addresses for LATOYA M. WALLACE (PA)

  • 1717 N E St

    208

    Pensacola, FL 325016339

    Phone: (850) 469-7771

    Type: Location

  • Eggplant Systems and Design, LLC, 1010, North 12th Avenue, East Hill, Pensacola, Escambia County, Florida, 32501, United States

    PENSACOLA, FL 325013370

    Phone: (410) 908-7714

    Fax: (850) 203-4629

    Type: Mailing

  • 125, North 12th Avenue, Pensacola, Escambia County, Florida, 32502, United States

    PENSACOLA, FL 325013315

    Phone: (850) 361-8598

    Fax: (850) 203-4629

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $197.

Total Amount is formed as General ($197) + Research ($0) + Ownership ($0) = $197.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($113).

Total Amount

$197

General + Research + Ownership

Payments

2

Total payment records

General Amount

$197

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638215734View full group profile

Reviews

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Frequently asked questions

How is LATOYA M. WALLACE (PA) identified in CMS data?
CMS-hosted NPPES data lists LATOYA M. WALLACE (PA) with NPI 1073764114.
Is LATOYA M. WALLACE (PA) listed as active for patients and plans?
The listing shows LATOYA M. WALLACE (PA) as active in the NPI system.
What is LATOYA M. WALLACE (PA)'s primary classification?
Physician Assistant is the headline specialty for LATOYA M. WALLACE (PA) here. Clinical services aligned with this taxonomy classification.
Where should I expect LATOYA M. WALLACE (PA) on a map?
Expect Pensacola, Florida as a primary anchor for LATOYA M. WALLACE (PA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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