GRANT WALLACE DPT
NPI 1386514339
Physical Therapist in Daytona Beach, FL

Active since November 06, 2025Accepts Medicare Assignment
1865 LPGA BLVD, DAYTONA BEACH, FL 32117(386) 255-4596(386) 258-3561 Get Directions Write a Review

NPPES record last updated: November 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 13, 2025, Nov 6, 2025 (2 updates tracked since 2025).

About Grant Wallace Dpt NPPES

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

GRANT WALLACE DPT (NPI 1386514339) is an individual physical therapist in Daytona Beach, Florida, licensed in Florida (PT43773) and active in the NPI registry since November 2025. He maintains 3 additional practice locations and is a graduate of Other (2025).

NPPES Registry Identity

NPI1386514339
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameGRANT WALLACECredential: DPT
Location Address1865 LPGA BLVDDaytona Beach, FL 32117-7108
Mailing Address1865 Lpga BlvdDaytona Beach, FL 32117-7108 · (386) 255-4596 · Fax (386) 258-3561
Fax(386) 258-3561
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 6, 2025
Last NPPES UpdateNovember 13, 20252 updates tracked since enumeration
NPPES CertifiedNovember 13, 2025
NPI 1386514339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in FL · PT43773
Definition

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:<ul><li>Diagnose and manage movement dysfunction and enhance physical and functional abilities.</li><li>Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.</li><li>Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.</li><li>Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.</li><li>Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.</li></ul>PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

1865 LPGA BLVD, Daytona Beach, FL 32117

Secondary Practice Locations 3

Location 11890 Lpga Blvd Ste 240Daytona Beach, FL 32117-7131 · Phone (386) 255-4596 · Fax (386) 258-3561
Location 217 Old Kings RdPalm Coast, FL 32137-8282 · Phone (386) 255-4596 · Fax (386) 258-3561
Location 31165 Dunlawton Ave Ste 102Port Orange, FL 32127-2924 · Phone (386) 255-4596 · Fax (386) 258-3561

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Grant Wallace Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709378326
PECOS Enrollment IDI20251121001529

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32117 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
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

Physician Assistant
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Orthopaedic Surgery
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Orthopaedic Surgery
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Orthopaedic Surgery
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Orthopaedic Surgery
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Physical Therapist
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Physician Assistant
1865 LPGA BLVD
DAYTONA BEACH, FL 32117
Physical Therapist
1865 LPGA BLVD
DAYTONA BEACH, FL 32117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grant Wallace's NPI number?

The NPI number for Grant Wallace is 1386514339. It was assigned to this individual provider in the NPPES registry on November 6, 2025.

Where is Grant Wallace located?

Grant Wallace practices at 1865 Lpga Blvd, Daytona Beach, FL 32117. The listed phone number is (386) 255-4596.

What is Grant Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Grant Wallace enrolled in Medicare?

Yes. Grant Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Grant Wallace was last updated on November 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.