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DONNA M WALLACE ARPN
NPI 1154577047
Nurse Practitioner - Family in Bridgeport, CT

Active since August 12, 2008PECOS Enrolled
46 ALBION ST, BRIDGEPORT, CT 06605(203) 330-6000(203) 330-6007 Get Directions Write a Review

NPPES record last updated: August 22, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Donna M Wallace Arpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DONNA M WALLACE ARPN (NPI 1154577047) is an individual family provider in Bridgeport, Connecticut, licensed in Connecticut (003840) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154577047
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDONNA M WALLACECredential: ARPN
Location Address46 ALBION STBridgeport, CT 06605-2602
Mailing Address46 Albion St, Southwest Community Health Center, IncBridgeport, CT 06605-2602 · (203) 332-3155 · Fax (203) 330-6008
Phone(203) 330-6000
Fax(203) 330-6007
Sole ProprietorNo
Enumeration DateAugust 12, 2008
Last NPPES UpdateAugust 22, 2014
✔ NPI 1154577047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CT · 003840
46 ALBION ST, Bridgeport, CT 06605
Open in Google Maps ↗

Other Identifiers 2

Medicaid004236130CT
Other003840CT · State License 003840

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Donna M Wallace Arpn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Donna Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Impact Health P.C.
13 mi
Nurse Practitioner
240 INDIAN RIVER RD STE C7
Orange, CT 06477
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Impact Health PC
  • 129 clinicians in this Medicare group
NPI 1730694316 (203) 497-3861
Matrix Medical Plus
809 mi
Nurse Practitioner
424 CHURCH ST STE 2600
Nashville, TN 37219
  • Reassigned Medicare billing, Connecticut enrollment
  • 79 clinicians in this Medicare group
NPI 1376973461 (877) 564-3627

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENDRA N DASCANO LPC-A
Counselor
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DR. SAMANTHA MRAZ DNP
Nurse Practitioner (Psychiatric/Mental Health)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 332-3584
MARLENE CUEVAS
Nurse Practitioner (Psychiatric/Mental Health)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (845) 664-3367
CLAUDE LOUIS
Counselor (Professional)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 644-4422
MRS. CLAUDIA PREISICK LPC
Counselor (Professional)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DANA BRUNELL EISENBERG
Nurse Practitioner (Pediatrics)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
DR. STEVE SHAH MD
Family Medicine
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000
BRITTNEY MARIE CIFARELLI DNP
Nurse Practitioner (Pediatrics)
46 ALBION ST
BRIDGEPORT, CT 06605
Greater Bridgeport Planning Region (203) 330-6000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donna Wallace's NPI number?

The NPI number for Donna Wallace is 1154577047. It was assigned to this individual provider in the NPPES registry on August 12, 2008.

Where is Donna Wallace located?

Donna Wallace practices at 46 Albion St, Bridgeport, CT 06605. The listed phone number is (203) 330-6000.

What is Donna Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Donna Wallace enrolled in Medicare?

Yes. Donna Wallace is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Donna Wallace's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Donna Wallace reassigns Medicare benefits to 2 organizations: Impact Health P.C. (Orange, CT) and Matrix Medical Plus (Nashville, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Donna Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Donna Wallace was last updated on August 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.