DONNA C WALLACE PNP
NPI 1346236122
Nurse Practitioner - Pediatrics in Phoenix, AZ

Q: What is Donna Wallace's NPI number?

The NPI number for Donna Wallace is 1346236122. It was assigned to this individual provider in the NPPES registry on September 27, 2005.

Q: What is Donna Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Donna Wallace was last updated on September 3, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 27, 2005PECOS Enrolled

2910 N 3RD AVE, PHOENIX, AZ 85013(602) 406-3632(602) 406-6126 Get Directions Write a Review

NPPES record last updated: September 3, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Donna C Wallace Pnp NPPES

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

DONNA C WALLACE PNP (NPI 1346236122) is an individual pediatrics provider in Phoenix, Arizona, licensed in Arizona (RN041572) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346236122

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameDONNA C WALLACECredential: PNP

Location Address2910 N 3RD AVEPhoenix, AZ 85013-4434

Mailing Address2910 N 3rd AvePhoenix, AZ 85013-4434 · (602) 406-3632 · Fax (602) 406-6126

Phone(602) 406-3632

Fax(602) 406-6126

Sole ProprietorNo

Enumeration DateSeptember 27, 2005

Last NPPES UpdateSeptember 3, 2014

✔ NPI 1346236122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in AZ · RN041572

2910 N 3RD AVE, Phoenix, AZ 85013

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Other Identifiers 2

Medicare ID-Type Unspecified70047AZ

Medicare UPINP58802

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Donna C Wallace Pnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85013 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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 19

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

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