KIMBERLY DIANE WALLINGFORD – Physical Therapist, NPI 1104369164

KIMBERLY DIANE WALLINGFORD is a healthcare provider. based in Portland, Maine. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT4737 (ME). The NPI Number for KIMBERLY DIANE WALLINGFORD is 1104369164

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY DIANE WALLINGFORD
NPI
1104369164
Phone
(207) 536-0702
Address
331 VERANDA ST
Enumeration Date
23 November 2016
Last Update Date
29 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2078848923
Graduation Year
2016 (10 years ago)
PAC ID
6800177635
Group Practice PAC ID
7618872086
Professional Enrollment ID
I20170110000372
Address ID
ME040112606BR114XXRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

628 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ME

Provider Addresses for KIMBERLY DIANE WALLINGFORD

  • 331 VERANDA ST

    BUILDING 6, RM 3311

    PORTLAND, ME 041035545

    Phone: (207) 536-0702

    Fax: (207) 536-0785

    Type: Location

  • 73 NEWTON RD

    STE 101

    PLAISTOW, NH 038652424

    Phone: (978) 388-7272

    Fax: (978) 388-7373

    Type: Mailing

  • 114 BATH RD STE 201

    BRUNSWICK, ME 040112606

    Phone: (207) 884-8923

    Fax: (207) 884-8972

    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: 2017-01-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170110000372IPhysical Therapist In Private PracticeMETBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes53139$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes34341$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes27333$0
97530Therapy procedure using functional activities14926$0
97162Evaluation for physical therapy, typically 30 minutes2221$0
View full utilization report →

Insurance plans in this area (ZIP 04103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618872086View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeME
Physical Therapist In Private PracticeNH
Physical Therapist In Private PracticeNH
-ME
Physical Therapist In Private PracticeNH
Physical Therapist In Private PracticeNH
-NH
Physical Therapist In Private PracticeME
Physical Therapist In Private PracticeMA
-MA

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Frequently asked questions

What identifier follows KIMBERLY DIANE WALLINGFORD across health systems?
The NPI 1104369164 uniquely identifies KIMBERLY DIANE WALLINGFORD in U.S. healthcare data.
Does the public listing show KIMBERLY DIANE WALLINGFORD as active?
KIMBERLY DIANE WALLINGFORD's NPI record reflects an active status in NPPES.
What does the directory say KIMBERLY DIANE WALLINGFORD does?
Insurance directories may phrase it differently, but here KIMBERLY DIANE WALLINGFORD maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Can patients visit KIMBERLY DIANE WALLINGFORD in Portland, Maine?
For routing, start with Portland, Maine for KIMBERLY DIANE WALLINGFORD, then verify phone and hours locally.
Who maintains KIMBERLY DIANE WALLINGFORD's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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