Donald John Wallace, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

X008217-1 Issued in NY

Practice address

20 Gilbert Ave Ste 201
Smithtown, NY 11787-5312

Phone

(631) 360-0170

Fax

(631) 724-1991

NPI assigned

Dec 13, 2006

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 NY

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Long Island Chiropractic, Physical Therapy and Nurse Practitioner in aGroup PAC ID 1658851985, 4 clinicians

Long Island Chiropractic and Physical Therapy PLLCGroup PAC ID 3779735691, 4 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 and National Provider Directory roles.

• Long Island Chiropractic & Physical Therapy, PLLC

  • Chiropractor
  • Smithtown, NY
  • NPI 1417207028
  Medicare reassignment Care Compare group NPD Authorized official
• Long Island Chiropractic, Physical Therapy & Nurse Practitioner in Adult Health of Smithtown, PLLC

  • Rehabilitation Chiropractor
  • Smithtown, NY
  • NPI 1013720713
  Medicare reassignment Care Compare group NPD Authorized official
• Li Chiropractic & Nurse Practitioner in Adult Health, PLLC

  • Chiropractor
  • Smithtown, NY
  • NPI 1245184266
  NPD Authorized official
• Edison R. Blanco Physician PC

  • Family Medicine Physician
  • Bay Shore, NY
  • NPI 1669631032
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1891856738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GILBERT AVE STE 201",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875312",
            "telephone_number": "631-360-0170",
            "fax_number": "631-724-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GILBERT AVE STE 201",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875312",
            "telephone_number": "631-360-0170",
            "fax_number": "631-724-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DONALD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "X008217-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Eastern Co Inc
• Kelly A Walker, CNM
• Pamella Ann Walker, PA-C
• David A Wallman, D.C.
• Allison Wallshein
• Karen Walsh, LMSW
• Susan Walton, RN, NP
• Eugene Wang, MD

• Rehabilitation Chiropractor in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Rehabilitation Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.