David Wallace

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

005919 Issued in CT

Practice address

275 Mount Carmel Ave
Hamden, CT 06518-1908

Phone

(203) 582-8234

NPI assigned

Jun 13, 2025

Last updated

Jun 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab by Rvna LLCGroup PAC ID 2466747019, 25 clinicians

Rvnahealth, IncGroup PAC ID 7416990569, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehab by Rvna, LLC

  • Rehabilitation Clinic/Center
  • Ridgefield, CT
  • NPI 1285082099
  Medicare reassignment Care Compare group NPD
• Rvnahealth, Inc.

  dba Ridgefield Visiting Nurse Association

  • Home Health Agency
  • Ridgefield, CT
  • NPI 1497758874
  Medicare reassignment Care Compare group NPD
• Rvnahealth, Inc.

  • Community Based Hospice Care Agency
  • Ridgefield, CT
  • NPI 1619491107
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1326934811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181908",
            "telephone_number": "203-582-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MOUNT CARMEL AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065181908",
            "telephone_number": "203-582-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CT",
            "license": "005919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3545)
• Walgreen Co (Walgreens #02410)
• Walgreen Co (Walgreens #05406)
• Walgreen Co (Walgreens #09101)
• Joyce Elizabeth Wall, EDD, MSN, AGPCNP-C
• Milton B Wallack, D.D.S.
• Kristen S Wallis, MD
• David Howland Wang, MD
• Barbara Ann Ward, RPH
• Tristan Ward

• Geriatric Physical Therapist in Hamden, CT
• Providers in Hamden, CT by specialty
• Geriatric Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.