DR. PAUL R. WALLACE M.D.
NPI 1306875869
Family Medicine in Clearwater, FL

Q: What is Paul Wallace's NPI number?

The NPI number for Paul Wallace is 1306875869. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Q: What is Paul Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Wallace was last updated on February 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 30, 2006PECOS Enrolled

855 S HIGHLAND AVE, CLEARWATER, FL 33756(727) 219-1833(727) 330-2908 Get Directions Write a Review

NPPES record last updated: February 17, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 17, 2022, Jun 11, 2021 (2 updates tracked since 2021).

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About Dr. Paul R. Wallace M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL R. WALLACE M.D. (NPI 1306875869) is an individual family medicine provider in Clearwater, Florida, licensed in Florida (ME69904) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306875869

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. PAUL R. WALLACECredential: M.D.

Location Address855 S HIGHLAND AVEClearwater, FL 33756-4446

Mailing Address1301 2nd Ave SwLargo, FL 33770-3120 · (727) 584-7706 · Fax (727) 581-3727

Phone(727) 219-1833

Fax(727) 330-2908

Sole ProprietorNo

Enumeration DateJune 30, 2006

Last NPPES UpdateFebruary 17, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 17, 2022

✔ NPI 1306875869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · ME69904

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

855 S HIGHLAND AVE, Clearwater, FL 33756

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Paul R. Wallace M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Paul Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dedicated Senior Medical Center Of Florida, LLC

5.0 mi

Specialist

7050 ULMERTON RD
Largo, FL 33771

Reassigned Medicare billing, Florida enrollment
348 clinicians in this Medicare group

NPI 1659888741 (305) 628-6117

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33756 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers19 claims68 services$6.96 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers30 claims30 services$208.41 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HUZAIFA HUSSAIN HAKIM DO

Internal Medicine