MARISA WALLACE DPT
NPI 1861115362
Physical Therapist in Hampstead, NC
About Marisa Wallace Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARISA WALLACE DPT (NPI 1861115362) is an individual physical therapist in Hampstead, North Carolina, licensed in North Carolina (P21665) and active in the NPI registry since September 2022. She is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- 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.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
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
Marisa 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.
Medicare Billing Reassignments
2Medicare enrollment records show Marisa Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hampstead, NC 28443
- Reassigned Medicare billing, North Carolina enrollment
- 5 clinicians in this Medicare group
Wilmington, NC 28403
- Reassigned Medicare billing, North Carolina enrollment
- 45 clinicians in this Medicare group
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 28443 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Marisa Wallace's NPI number?
The NPI number for Marisa Wallace is 1861115362. It was assigned to this individual provider in the NPPES registry on September 21, 2022.
Where is Marisa Wallace located?
Marisa Wallace practices at 14057 Us Highway 17 Ste 230, Hampstead, NC 28443. The listed phone number is (910) 821-3377.
What is Marisa Wallace's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Marisa Wallace enrolled in Medicare?
Yes. Marisa 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.
Which organizations bill Medicare for Marisa Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marisa Wallace reassigns Medicare benefits to 2 organizations: Pender Pelvic Health And Therapy Services, LLC (Hampstead, NC) and Zumbro And Connell, Inc (Wilmington, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marisa Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Marisa Wallace was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Marisa Wallace, DPT · NPI 1861115362
Physical Therapist provider in Hampstead, North Carolina. Individual provider, active in the CMS NPPES registry since September 21, 2022.
## Identity
- **NPI:** 1861115362 (Entity type: Individual)
- **Enumerated:** September 21, 2022
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** P21665 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 14057 US HIGHWAY 17 STE 230, Hampstead, NC 28443-3999
- **Phone:** (910) 821-3377 · **Fax:** (910) 821-3380
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Pender Pelvic Health And Therapy Services, LLC (NPI 1235713074, Hampstead, NC); Zumbro And Connell, Inc (NPI 1750567889, Wilmington, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** November 21, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1861115362) · Data from the CMS NPPES public registry.