Donna M Wallace, ARPN - Medicare Nurse Practitioner in Bridgeport, CT

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Donna M Wallace, ARPN is a medicare enrolled "Nurse Practitioner - Family" in Bridgeport, Connecticut. Her current practice location is 46 Albion St, Bridgeport, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 330-6000.

Donna M Wallace is licensed to practice in Connecticut (license number 003840) 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 1154577047.

Contact Information

Donna M Wallace, ARPN
46 Albion St,
Bridgeport, CT 06605-2602
(203) 330-6000
(203) 330-6007

Map and Direction




Provider's Profile

Full NameDonna M Wallace
GenderFemale
SpecialityNurse Practitioner - Family
Location46 Albion St, Bridgeport, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1154577047
  • Provider Enumeration Date: 08/12/2008
  • Last Update Date: 08/22/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 2567538846
  • Enrollment ID: I20080910000573

Medical Identifiers

Medical identifiers for Donna M Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154577047NPI-NPPES
003840OtherCTSTATE LICENSE 003840
004236130MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 003840 (Connecticut)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 M Wallace allows following entities to bill medicare on her behalf.
Entity NameImpact Health Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730694316
PECOS PAC ID: 0941562664
Enrollment ID: O20180316001315

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 M 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 M Wallace, ARPN
46 Albion St, Southwest Community Health Center, Inc,
Bridgeport, CT 06605-2602

Ph: (203) 332-3155		Donna M Wallace, ARPN
46 Albion St,
Bridgeport, CT 06605-2602

Ph: (203) 330-6000

Reviews and Comments


Nurse Practitioner Nurses in Bridgeport, CT

Ryan Keenan, PMHNP
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Practice Location: 267 Grant St, Bridgeport, CT 06610
Phone: 203-384-3000    
Caroline Mead Farrell,
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Phone: 908-489-4847    
Miss Sandra Shipkowitz, APRN
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Practice Location: 267 Grant St, Bridgeport, CT 06610
Phone: 203-384-4490    
Patricia Anne Simpson, APRN
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Medicare: Accepting Medicare Assignments
Practice Location: 267 Grant St, Bridgeport, CT 06610
Phone: 203-368-3000    
Dr. Samantha Mraz, DNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 46 Albion St, Bridgeport, CT 06605
Phone: 203-332-3584    
Esther M Mervil, APRN
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Medicare: Accepting Medicare Assignments
Practice Location: 471 Barnum Ave, Bridgeport, CT 06608
Phone: 203-333-6864    Fax: 203-332-0376
Asena Derohannesian,
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Medicare: Medicare Enrolled
Practice Location: 425 Thorme St, Bridgeport, CT 06606
Phone: 203-275-4115    Fax: 203-275-0198

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.