COLLIN WILLIAM WALLACE DPT
NPI 1568830719
Physical Therapist - Orthopedic in Riverview, FL

Q: What is Collin Wallace's NPI number?

The NPI number for Collin Wallace is 1568830719. It was assigned to this individual provider in the NPPES registry on September 4, 2015.

Q: What is Collin Wallace's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: When was this NPI record last updated?

The NPPES record for Collin Wallace was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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 September 04, 2015Accepts Medicare Assignment

11375 BIG BEND RD, RIVERVIEW, FL 33579(813) 805-8167(844) 214-1382 Get Directions Write a Review

NPPES record last updated: March 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 2, 2026, Nov 18, 2016 (2 updates tracked since 2016).

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About Collin William Wallace Dpt NPPES

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

COLLIN WILLIAM WALLACE DPT (NPI 1568830719) is an individual orthopedic provider in Riverview, Florida, licensed in Florida (PT30787) and active in the NPI registry since September 2015. He maintains a secondary practice location in Clearwater and is a graduate of Other (2015).

NPPES Registry Identity

NPI1568830719

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameCOLLIN WILLIAM WALLACECredential: DPT

Location Address11375 BIG BEND RDRiverview, FL 33579-7183

Mailing Address11375 Big Bend RdRiverview, FL 33579-7183 · (813) 805-8167 · Fax (844) 214-1382

Phone(813) 805-8167

Fax(844) 214-1382

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateSeptember 4, 2015

Last NPPES UpdateMarch 2, 20262 updates tracked since enumeration

NPPES CertifiedMarch 2, 2026

✔ NPI 1568830719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

License✔ Licensed in FL · PT30787

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

Also ListedPhysical TherapistTaxonomy 225100000X · License PT30787 (FL)

11375 BIG BEND RD, Riverview, FL 33579

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Secondary Practice Location 1

Location 12349 Sunset Point Rd Ste 400Clearwater, FL 33765-1439 · Phone (970) 371-8965

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Collin William 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 ID42591109

PECOS Enrollment IDI20170103001453

Medicare Billing Reassignments

Medicare enrollment records show Collin Wallace reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Optimal Performance And Physical Therapies-Riverview, LLC

Same address

Physical Therapist

11375 BIG BEND RD
Riverview, FL 33579

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

NPI 1063810505 (813) 690-4494

Optimal Performance And Physical Therapies-Brandon LLC

11 mi

Physical Therapist

1056 E BRANDON BLVD
Brandon, FL 33511

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

NPI 1407132632 (813) 690-4414

Ohi West Medical Group, LLC

20 mi

Cardiovascular Disease

701 6TH ST S
St Petersburg, FL 33701

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

NPI 1518572551 (727) 823-1234

Orlando Health Medical Group Inc

76 mi

Internal Medicine

52 W UNDERWOOD ST
Orlando, FL 32806

Reassigned Medicare billing, Florida enrollment
3,290 clinicians in this Medicare group

NPI 1669429577 (321) 841-2452

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

565 services55 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

438 services53 patients

Therapy procedure using functional activities 97530

A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.

141 services32 patients

Therapy procedure using manual technique, each 15 minutes 97140

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

38 services16 patients

Therapy procedure for walking training, each 15 minutes 97116

Walking training therapy is a process to improve your ability to walk. It's a 15-minute session where you'll practice walking with the help of devices or exercises. It aims to enhance balance, strength, coordination, and endurance.

31 services14 patients

Evaluation for physical therapy, typically 30 minutes 97162

An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.

24 services23 patients

Other Providers at the Same Location NPPES 12

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

OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES-RIVERVIEW, LLC

Physical Therapist