Paul Michael Wallace, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD19363 Issued in RI

Practice address

528 N Main St
Providence, RI 02904

Phone

(401) 528-0123

Fax

(401) 528-0124

NPI assigned

Mar 18, 2019

Last updated

Dec 18, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Providence Center IncGroup PAC ID 9739080292, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.wallace.1@20649.direct.athenahealth.com
• Direct secure messaging: pwallace@direct.carene.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Providence Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Providence, RI
  • NPI 1104847946

  Psychiatry

  Medicare reassignment Care Compare group NPD
• The Rhode Island Public Health Foundation

  dba Open Door Health

  • Clinic/Center
  • Providence, RI
  • NPI 1669024329
  Medicare reassignment NPD
• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662

  Psychiatry

  NPD
• The Providence Center

  • Community/Behavioral Health Agency
  • Providence, RI
  • NPI 1134977598

  Psychiatry

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Women & Infants Hospital of Rhode Island

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1447233788
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1265991335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N MAIN ST UNIT 4",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045770",
            "telephone_number": "401-528-0123",
            "fax_number": "401-528-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-528-0123",
            "fax_number": "401-528-0124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 N Main St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029045762",
            "country_code": "US",
            "telephone_number": "401-274-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD19363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Barta Wall, MD
• Gemma Wallace, PHD
• Jacqueline Wallace, RN
• Jailene Wallace, FNP-C
• Joan Wallace, NP
• Nicholas Walle
• Ann Marie Wallick, CRNA
• Brittany Meaghan Wallin, CRNA
• Barbara Anne Walsh Egan
• Caroline Walsh, MD, MPAFF

• Psychiatry Physician in Providence, RI
• Providers in Providence, RI by specialty
• Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.