Grace Wall, PT, DPT
NPI 1164246641ActiveIndividual· Physical Therapist· Hainesport, NJ
Physical Therapist (PT, DPT) with Ipta Clinical, LLC, practicing in Hainesport, New Jersey. Enrolled in Medicare as practitioner - physical therapist in private practice and practitioner - physical therapist in private practice.
Overview
| NPI | 1164246641 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Nov 12, 2024 |
| Last updated in NPPES | Nov 12, 2024 |
| Certified by provider | Nov 12, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 40QA02300800 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (NJ); Practitioner - Physical Therapist in Private Practice (PA) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Ipta Clinical, LLCMedford, NJ · 128 clinicians
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