MASON WALLACE – Physical Therapist, NPI 1033500525

MASON WALLACE is a healthcare provider. based in Alexandria, Virginia. specializing in Physical Therapist. They hold a License No. 2305209278 (VA). The NPI Number for MASON WALLACE is 1033500525

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
MASON WALLACE
NPI
1033500525
Phone
(703) 299-6688
Address
209 MADISON ST
Enumeration Date
5 February 2015
Last Update Date
5 February 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4252077043
Graduation Year
2014 (12 years ago)
PAC ID
3779801493
Group Practice PAC ID
7810892072
Professional Enrollment ID
I20190529002404
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for MASON WALLACE

  • 209 MADISON ST

    SUITE LL2

    ALEXANDRIA, VA 223141764

    Phone: (703) 299-6688

    Fax: (703) 299-3588

    Mailing address matches the actual address.

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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 22314)

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Provider's Procedures

MASON WALLACE performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYVA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes82783
PHYSICAL THERAPYVA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes103980

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: 7810892072View full group profile

Reviews

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Frequently asked questions

How do payers reference MASON WALLACE?
For MASON WALLACE, use NPI 1033500525 as the unique 10-digit identifier.
Would MASON WALLACE appear as active to a payer?
You can treat MASON WALLACE as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with MASON WALLACE?
MASON WALLACE's record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with MASON WALLACE?
Directory geography for MASON WALLACE centers on Alexandria, Virginia.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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