LINDSEY AVERY WALLACE (PT, DPT) – Physical Therapist, NPI 1255075800

LINDSEY AVERY WALLACE (PT, DPT) is a healthcare provider. based in Ephrata, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT.61256288 (WA). The NPI Number for LINDSEY AVERY WALLACE (PT, DPT) is 1255075800

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
LINDSEY AVERY WALLACE (PT, DPT)
NPI
1255075800
Phone
(208) 596-6929
Address
200 Nat Washington Way
Enumeration Date
20 April 2022
Last Update Date
20 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097544631
Graduation Year
2022 (4 years ago)
PAC ID
7012352024
Group Practice PAC ID
6709775166
Professional Enrollment ID
I20240229002693
Address ID
WA988231997EP200XXWAYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for LINDSEY AVERY WALLACE (PT, DPT)

  • 200 Nat Washington Way

    Ephrata, WA 988231982

    Phone: (208) 596-6929

    Type: Location

  • 402 Q ST SW

    QUINCY, WA 988487802

    Phone: (208) 596-6929

    Type: Mailing

  • 406 CENTRAL AVE S

    QUINCY, WA 988481226

    Phone: (208) 596-6929

    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: 2024-02-29

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
I20240229002693IPhysical Therapist In Private PracticeWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98823)

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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: 6709775166View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOR
Cardiovascular Disease (Cardiology)WA
Physical Therapist In Private PracticeWA
Physician AssistantWA
Diagnostic RadiologyWA
Qualified Speech Language PathologistOK
Occupational Therapist In Private PracticeCA
Physician AssistantFL
Diagnostic RadiologyWA
Emergency Medicine, Family PracticeWA

Reviews

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Frequently asked questions

Can I cross-check LINDSEY AVERY WALLACE (PT, DPT) using NPI 1255075800?
NPI 1255075800 belongs to LINDSEY AVERY WALLACE (PT, DPT); compare other details if you need extra assurance.
Is LINDSEY AVERY WALLACE (PT, DPT) shown as active in public data?
Registry records indicate LINDSEY AVERY WALLACE (PT, DPT) maintains an active NPI.
What expertise is attributed to LINDSEY AVERY WALLACE (PT, DPT)?
LINDSEY AVERY WALLACE (PT, DPT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is LINDSEY AVERY WALLACE (PT, DPT) associated with Ephrata?
Public fields place LINDSEY AVERY WALLACE (PT, DPT) around Ephrata, Washington. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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