Dr Colby Evan Wallace, DPT in Atlanta, GA - Medicare Physical Therapist Provider

Dr Colby Evan Wallace, DPT is a medicare enrolled "Physical Therapist - Neurology" provider in Atlanta, Georgia. His current practice location is 12 Executive Park Dr Ne, Atlanta, Georgia. You can reach out to his office (for appointments etc.) via phone at (404) 778-3444.

Dr Colby Evan Wallace is licensed to practice in Georgia (license number PT012499) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457806622.

Contact Information

	Dr Colby Evan Wallace, DPT
	12 Executive Park Dr Ne, Atlanta, GA 30329-2206
	(404) 778-3444
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Colby Evan Wallace
Gender	Male
Speciality	Physical Therapist - Neurology
Location	12 Executive Park Dr Ne, Atlanta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457806622
Provider Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016

Medicare PECOS Information:

PECOS PAC ID: 8729456579
Enrollment ID: I20221129000360

Medical Identifiers

Medical identifiers for Dr Colby Evan Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457806622	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2251N0400X	Physical Therapist - Neurology	PT012499 (Georgia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Colby Evan Wallace allows following entities to bill medicare on his behalf.

Provider Name	Orthoatlanta, Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1851937114 PECOS PAC ID: 3971406885 Enrollment ID: O20040129000005

Provider Name	Atlanta Rehabilitation And Performance Center
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1982797494 PECOS PAC ID: 5890692917 Enrollment ID: O20060421000284

Provider Name	Piedmont Orthopedics, Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1114317062 PECOS PAC ID: 4385963172 Enrollment ID: O20150429000361

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Colby Evan Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Colby Evan Wallace, DPT 7208 Northlake Heights Cir Ne, Atlanta, GA 30345-2262 Ph: (615) 653-9596	Dr Colby Evan Wallace, DPT 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 Ph: (404) 778-3444

Reviews and Comments

Physical Therapist in Atlanta, GA

Mrs. Joel Adrianna Bruno, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 390 Stovall St Se, Apt 3109, Atlanta, GA 30316 Phone: 404-719-2515
Erin G Kent, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1867 Harvard Ave, Atlanta, GA 30337 Phone: 404-835-4321 Fax: 404-835-4320
Taylor Morris Gayle, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 860 Johnson Fy Rd Ne, Ste 100, Atlanta, GA 30342 Phone: 404-252-5545 Fax: 404-252-5511
Elizabeth Ashley Smith, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 800 Peachtree St Ne Ste E2, Atlanta, GA 30308 Phone: 404-254-3319
Spencer Edward Kasmere, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 925 Garrett St Se Ste J, Atlanta, GA 30316 Phone: 404-624-5407 Fax: 404-624-5409
Natalie Muniz, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3280 Howell Mill Rd Nw Ste 303, Atlanta, GA 30327 Phone: 470-300-6030 Fax: 470-300-6031
Ogoluwakitan Cal Lawanson, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3200 Downwood Cir Nw Ste 700, Atlanta, GA 30327 Phone: 404-355-0743

Dr Colby Evan Wallace, DPT - Medicare Physical Therapist in Atlanta, GA