Fabiola Corbette Wallace, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

338132 Issued in NY

Practice address

1790 Broadway Ste 1802
New York, NY 10019-1471

Phone

(212) 530-0624

Fax

(415) 252-7176

NPI assigned

May 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Family Practice

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• One Medical of Ny, P.C.

  • Family Medicine Physician
  • New York, NY
  • NPI 1861709487
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD
• Mount Sinai School of Medicine

  • Internal Medicine Physician
  • Manhasset, NY
  • NPI 1144659749
  NPD (past)

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1932847282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791",
            "fax_number": "845-338-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 BROADWAY STE 1802",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191471",
            "telephone_number": "212-530-0624",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Family Practice Dr",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124016449",
            "country_code": "US",
            "telephone_number": "845-338-6400",
            "fax_number": "845-339-7288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORBETTE WALLACE",
        "first_name": "FABIOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "338132",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ken Corbett, PHD
• Lynn King Corbett, LMSW
• Virginia Corbett
• Claire Madeleine Corbetta, LMSW
• Ricardo Corbetta, PH.D.
• April Lynn Corbin, PHARMD
• Davian Corbin
• Jeffrey Scott Corbin, MD
• Rebecca Corbin, CPNP-PC
• Samantha Corbin

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.