Anthony Paul Wallace, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10294 Issued in CA

Practice address

5255 El Camino Real Ste C
Atascadero, CA 93422-3351

Phone

(805) 237-0272

Fax

(805) 237-2416

NPI assigned

Jul 12, 2005

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paso Robles Physical Therapy IncGroup PAC ID 7315376357, 7 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.

• Paso Robles Physical Therapy Inc

  • Physical Therapist
  • Atascadero, CA
  • NPI 1609414416
  Medicare reassignment Care Compare group NPD Authorized official
• Anthony Wallace

  dba Paso Robles Physical Therapy

  • Physical Therapist
  • Paso Robles, CA
  • NPI 1720086838
  Authorized official Same address or phone

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1891793923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 EL CAMINO REAL STE C",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223351",
            "telephone_number": "805-237-0272",
            "fax_number": "805-237-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 EL CAMINO REAL STE C",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223351",
            "telephone_number": "805-237-0272",
            "fax_number": "805-237-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "10294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean A Waistell, P.T.
• Walgreen Co (Walgreens #07210)
• Sharon Dianne Walker, PHD
• Alessia C Wallace
• Alicia Wallace, BCBA
• Kimberly Wallace
• Amy Marie Watson, LCSW
• Briana Watson
• Richard Lee Watz, D.C.
• Christopher Allen Webb, PHD

• Physical Therapist in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.