COLLIN WILLIAM WALLACE (DPT) – Orthopedic Physical Therapist, NPI 1568830719
Orthopedic Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,633 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL
Provider Addresses for COLLIN WILLIAM WALLACE (DPT)
2349 SUNSET POINT RD STE 400
CLEARWATER, FL 337651439
Phone: (970) 371-8965
Type: Location
3903 NORTHDALE BLVD
STE 111W
TAMPA, FL 336241853
Phone: (813) 805-8167
Fax: (844) 214-1382
Type: Mailing
2349 Sunset Point Rd Ste 400
Clearwater, FL 337651439
Phone: (970) 371-8965
Type: Location
11375 BIG BEND RD
RIVERVIEW, FL 335797183
Phone: (813) 805-8167
Fax: (844) 214-1382
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2017-01-03
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 |
|---|---|---|---|---|
| I20170103001453 | I | Physical Therapist In Private 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 625 | 64 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 371 | 58 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 60 | 20 | $0 |
| 97530 | Therapy procedure using functional activities | 52 | 18 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 20 | 19 | $0 |
Insurance plans in this area (ZIP 33765)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | FL | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 92 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | FL | |
| - | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| - | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Therapist In Private Practice | AR |
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