DR. SHAWN G WALLACE (PT, DPT) – Physical Therapist, NPI 1457323396
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK
Provider Addresses for DR. SHAWN G WALLACE (PT, DPT)
13390 NE 23rd St
Choctaw, OK 730208622
Phone: (405) 769-5555
Fax: (405) 769-5558
Type: Location
1805 COMMONS CIR STE 100B
YUKON, OK 730999519
Phone: (405) 467-4086
Fax: (405) 467-4387
Type: Mailing
13390, Northeast 23rd Street, Choctaw, Oklahoma County, Oklahoma, 73020, United States
CHOCTAW, OK 730208622
Phone: (405) 769-5555
Fax: (405) 769-5558
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: 2010-04-07
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 |
|---|---|---|---|---|
| I20100407000304 | I | Physical Therapist In Private Practice | OK | 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 | 592 | 65 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 344 | 48 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 256 | 41 | $0 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 149 | 31 | $0 |
| 97012 | Application of mechanical traction | 111 | 19 | $0 |
Insurance plans in this area (ZIP 73020)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | OK | 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 968 | 109 |
| PHYSICAL THERAPY | OK | 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 571 | 97 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Occupational Therapist In Private Practice | OK |
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