MRS. CIJI DEYUANA WALLACE RN-FNP
NPI 1487455036
Nurse Practitioner - Family in Bogalusa, LA
About Mrs. Ciji Deyuana Wallace Rn-fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. CIJI DEYUANA WALLACE RN-FNP (NPI 1487455036) is an individual family provider in Bogalusa, Louisiana, licensed in Louisiana (240977) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Ciji Deyuana Wallace Rn-fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Ciji Wallace reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Diamondhead, MS 39525
- Reassigned Medicare billing, Mississippi enrollment
- 731 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Memorial Hospital At Gulfport
Acute Care Hospitals · Gulfport, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 70427 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ciji Wallace's NPI number?
The NPI number for Ciji Wallace is 1487455036. It was assigned to this individual provider in the NPPES registry on March 20, 2025.
Where is Ciji Wallace located?
Ciji Wallace practices at 219 S Border Dr, Bogalusa, LA 70427. The listed phone number is (985) 633-1952.
What is Ciji Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Ciji Wallace enrolled in Medicare?
Yes. Ciji Wallace is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Ciji Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ciji Wallace reassigns Medicare benefits to Memorial Hospital At Gulfport (Diamondhead, MS). The 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 Ciji Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ciji Wallace accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Cigna Healthcare and 4 other insurers list Ciji Wallace as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Ciji Wallace affiliated with any hospitals?
According to CMS data, Ciji Wallace is affiliated with Memorial Hospital At Gulfport.
When was this NPI record last updated?
The NPPES record for Ciji Wallace was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.
# Mrs. Ciji Deyuana Wallace, RN-FNP · NPI 1487455036
Family physician in Bogalusa, Louisiana. Individual provider, active in the CMS NPPES registry since March 20, 2025.
## Identity
- **NPI:** 1487455036 (Entity type: Individual)
- **Enumerated:** March 20, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 240977 (Louisiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 219 S BORDER DR, Bogalusa, LA 70427-3671
- **Phone:** (985) 633-1952 · **Fax:** (985) 732-4458
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Memorial Hospital At Gulfport (NPI 1346677812, Diamondhead, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** October 14, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1487455036) · Data from the CMS NPPES public registry.