Individual provider Active NPI

Wallace Henry Torbert III, PA-C

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1679169783
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9116491 Issued in FL
Practice address
1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628
Phone
(415) 658-6791
Fax
(415) 252-7176
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA101520 MA
Physician Assistant 363A00000X 010232 GA
Physician Assistant 363A00000X 11007 AZ
Physician Assistant 363A00000X PA.0009167 CO
Physician Assistant 363A00000X PA9116491 FL Primary

Addresses

Primary practice location

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Mailing address

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210305000489 GA Practitioner - Physician Assistant 9931515517 Reassigns benefits to 2 organizations
I20221110000646 FL Practitioner - Physician Assistant 9931515517 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Florida LLCGroup PAC ID 2466823711, 58 clinicians

Practice addresses (Care Compare)

2332 Galiano St
FL 2
Coral Gables, FL 33134-5402
Phone (337) 991-9276

65 Origins Pkwy
Inlet Beach, FL 32461-8702
Phone (337) 991-9276

95 Grand Heron Dr
Panama City Beach, FL 32407-2553
Phone (337) 991-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
010232GAMDSpeech-Language Pathologist
11007AZMDPhysician Assistant
PA.0009167COMDPhysician Assistant
PA9116491FLMDPhysician Assistant
PA101520MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Physician Practices LLC CurrentSince Feb 1, 2021 Accepting new patients
St Francis Physician Practices LLC CurrentSince Feb 1, 2021 Accepting new patients
Quality Drive Emergency Physicians LLC Past Accepting new patients

Locations

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2000 16th Ave
Columbus, GA 31901
Phone (706) 320-3700

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1679169783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "telephone_number": "415-658-6791",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORBERT",
        "first_name": "WALLACE",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101520",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "010232",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11007",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009167",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.