Donna C Wallace, PNP - Medicare Nurse Practitioner in Phoenix, AZ

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Donna C Wallace, PNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Phoenix, Arizona. Her current practice location is 2910 N 3rd Ave, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (602) 406-3632.

Donna C Wallace is licensed to practice in Arizona (license number RN041572) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1346236122.

Contact Information

Donna C Wallace, PNP
2910 N 3rd Ave,
Phoenix, AZ 85013-4434
(602) 406-3632
(602) 406-6126

Map and Direction




Provider's Profile

Full NameDonna C Wallace
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location2910 N 3rd Ave, Phoenix, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1346236122
  • Provider Enumeration Date: 09/27/2005
  • Last Update Date: 09/03/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 6507874427
  • Enrollment ID: I20060403000776

Medical Identifiers

Medical identifiers for Donna C Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1346236122NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics RN041572 (Arizona)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. Donna C Wallace allows following entities to bill medicare on her behalf.
Entity NameBanner -- University Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508809427
PECOS PAC ID: 7719899871
Enrollment ID: O20031105000694
Entity NameDistrict Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336472448
PECOS PAC ID: 7315086691
Enrollment ID: O20091125000583
Entity NameBanner Physician Super Specialists Arizona Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1841573870
PECOS PAC ID: 7911173794
Enrollment ID: O20111228000353
Entity NameBanner Hospital Based Physicians Arizona Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275889891
PECOS PAC ID: 3274782487
Enrollment ID: O20121003000752

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. Donna C 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 AddressPractice Location Address
Donna C Wallace, PNP
2910 N 3rd Ave,
Phoenix, AZ 85013-4434

Ph: (602) 406-3632		Donna C Wallace, PNP
2910 N 3rd Ave,
Phoenix, AZ 85013-4434

Ph: (602) 406-3632

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.