Laura Wallace, CNP, DNP-FNP - Medicare Nurse Practitioner in Rogers, MN

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Laura Wallace, CNP, DNP-FNP is a medicare enrolled "Nurse Practitioner - Family" in Rogers, Minnesota. Her current practice location is 14040 Northdale Blvd, Rogers, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 488-4100.

Laura Wallace is licensed to practice in Minnesota (license number 10747) 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 1215702683.

Contact Information

Laura Wallace, CNP, DNP-FNP
14040 Northdale Blvd,
Rogers, MN 55374-9612
(763) 488-4100
Not Available

Map and Direction




Provider's Profile

Full NameLaura Wallace
GenderFemale
SpecialityNurse Practitioner - Family
Location14040 Northdale Blvd, Rogers, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1215702683
  • Provider Enumeration Date: 11/16/2023
  • Last Update Date: 11/16/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6406292630
  • Enrollment ID: I20240311002635

Medical Identifiers

Medical identifiers for Laura Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215702683NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 10747 (Minnesota)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. Laura Wallace allows following entities to bill medicare on her behalf.
Entity NameFairview Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461
Entity NameFairview Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346432218
PECOS PAC ID: 7113830142
Enrollment ID: O20031106000516
Entity NameFairview Express Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053952606
PECOS PAC ID: 3375645179
Enrollment ID: O20081028000548

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. Laura 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
Laura Wallace, CNP, DNP-FNP
13060 42nd Ave Sw,
Pillager, MN 56473-2495

Ph: (763) 291-5193		Laura Wallace, CNP, DNP-FNP
14040 Northdale Blvd,
Rogers, MN 55374-9612

Ph: (763) 488-4100

Reviews and Comments


Nurse Practitioner Nurses in Rogers, MN

Angela Jo Rickheim,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 13688 Rogers Dr Ste 230, Rogers, MN 55374
Phone: 952-977-0300    Fax: 952-977-0311
Rebecca Ann Ahlstrom, APRN, CNP
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 21897 S Diamond Lake Rd Ste 400-403, Rogers, MN 55374
Phone: 763-317-1122    Fax: 855-282-6764
Mr. William N. Kunau, PNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 13980 Northdale Blvd, Rogers, MN 55374
Phone: 763-428-1920    Fax: 763-428-3162
Kara Lynn Lewis, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 14040 Northdale Blvd Ste 10, Rogers, MN 55374
Phone: 763-488-4100    
Vernon L Hanson, RN, NP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 13688 Rogers Dr, Suite 230, Rogers, MN 55374
Phone: 952-949-1035    
Mrs. Ali Margaret Wells, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 13688 Rogers Dr Ste 230, Rogers, MN 55374
Phone: 952-977-0300    

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.