KASSY ARLENE WALLACE (PT, DPT) – Orthopedic Physical Therapist, NPI 1790456614

KASSY ARLENE WALLACE (PT, DPT) is a healthcare provider. based in Kingsley, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 5501301778 (MI). The NPI Number for KASSY ARLENE WALLACE (PT, DPT) is 1790456614

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KASSY ARLENE WALLACE (PT, DPT)
NPI
1790456614
Phone
(231) 263-1350
Address
4040 Beacon St
Enumeration Date
21 September 2021
Last Update Date
18 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2318760010
Graduation Year
2022 (4 years ago)
PAC ID
3971987983
Group Practice PAC ID
8628986643
Professional Enrollment ID
I20220824003633
Address ID
MI496018482CA8872XDRXX305
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for KASSY ARLENE WALLACE (PT, DPT)

  • 4040 Beacon St

    Kingsley, MI 496499548

    Phone: (231) 263-1350

    Type: Location

  • 8872 PROFESSIONAL DR STE C

    CADILLAC, MI 496018482

    Phone: (231) 876-0010

    Fax: (231) 876-0241

    Type: Mailing

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: 2022-08-24

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
I20220824003633IPhysical Therapist In Private PracticeMITBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes66063$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes33849$0
97140Therapy procedure using manual technique, each 15 minutes24540$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care9128$0
97530Therapy procedure using functional activities5115$0
View full utilization report →

Insurance plans in this area (ZIP 49649)

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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: 8628986643View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
-MI
Physical Therapist In Private PracticeMI
-MI

Reviews

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Frequently asked questions

What is the 10-digit NPI for KASSY ARLENE WALLACE (PT, DPT)?
KASSY ARLENE WALLACE (PT, DPT) — NPI 1790456614 — is the standard way to identify this listing.
Can I rely on KASSY ARLENE WALLACE (PT, DPT) being an active provider?
As of the registry snapshot, KASSY ARLENE WALLACE (PT, DPT) is marked active.
What is KASSY ARLENE WALLACE (PT, DPT)'s specialty?
The listing groups KASSY ARLENE WALLACE (PT, DPT) with Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Does KASSY ARLENE WALLACE (PT, DPT) list a practice location?
Patients near Kingsley, Michigan may find KASSY ARLENE WALLACE (PT, DPT) in results; validate coverage separately.
Why does KASSY ARLENE WALLACE (PT, DPT) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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