Kassy Arlene Wallace, PT, DPT
NPI 1790456614ActiveIndividual· Physical Therapist, Orthopedic· Cadillac, MI
Physical Therapist, Orthopedic (PT, DPT) with Dynamic Physical Therapy Inc, practicing in Cadillac, Michigan. Medicare paid $27,108 for services to 63 patients in 2024.
Overview
| NPI | 1790456614 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT |
| Sole proprietor | No |
| NPI issued | Sep 21, 2021 |
| Last updated in NPPES | Aug 18, 2022 |
| Certified by provider | Aug 18, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist, Orthopedic Primary | 2251X0800X | 5501301778 | MI |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
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 (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 63 |
|---|---|
| Services billed | 1,458 across 10 procedure codes |
| Paid by Medicare | $27,108 |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Dynamic Physical Therapy IncCadillac, MI · 11 clinicians
Other Physical Therapist, Orthopedic providers in Cadillac
- 1811490352
- 1760716948