Individual provider Active NPI

Isabel Walls, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1952667560
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
30 Broad St FL 45
New York, NY 10004-2942
Phone
(212) 530-0630
NPI assigned
Apr 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

30 Broad St FL 45
New York, NY 10004-2942

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120517000609 MA Practitioner - Physician Assistant 9739342338 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Lifestyle Medical and Cardiovascular Associates PCGroup PAC ID 0941611016, 7 clinicians

Practice addresses (Care Compare)

112 Worcester St
Suite 303
Wellesley, MA 02481-3632
Phone (617) 916-9433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Affiliated Medical Group Inc. CurrentSince Feb 20, 2012 Accepting new patients
Lifestyle Medical and Cardiovascular Associates PC CurrentSince Aug 7, 2025 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Jan 1, 2020 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
Mass General Brigham Community Physicians Inc. PastSince Oct 16, 2022 Accepting new patients

Locations

300 Boylston St
Ste 201
Chestnut Hill, MA 02467
Phone (617) 831-7100

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

112 Worcester St
Wellesley, MA 02481

112 Worcester St
Ste 303
Wellesley Hills, MA 02481
Phone (617) 916-9433

Interoperability endpoints

  • Direct secure messaging: walls.isabel.nwh@direct.partners.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1952667560",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST FL 45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042942",
            "telephone_number": "212-530-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "ISABEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.