DR. PAUL R. WALLACE (M.D.) – Family Medicine Physician, NPI 1306875869
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. PAUL R. WALLACE (M.D.)
855 S HIGHLAND AVE
CLEARWATER, FL 337564446
Phone: (727) 219-1833
Fax: (727) 330-2908
Type: Location
1301, 2nd Avenue Southwest, Largo, Pinellas County, Florida, 33770, United States
LARGO, FL 337703120
Phone: (727) 584-7706
Fax: (727) 581-3727
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $117.
Total Amount is formed as General ($117) + Research ($0) + Ownership ($0) = $117.
Last reported payment date: 2024-09-13 • Largest payer in this snapshot: Abbott Laboratories ($117).
Total Amount
$117
General + Research + Ownership
Payments
1
Total payment records
General Amount
$117
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $117 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100617000565 | I | Family Practice | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 33756)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | FL | 83036 | Hemoglobin A1C level | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.