BRANDI WALLACE FNP
NPI 1982739900
Nurse Practitioner - Family in Fargo, ND
About Brandi Wallace Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRANDI WALLACE FNP (NPI 1982739900) is an individual family provider in Fargo, North Dakota, licensed in North Dakota (R30131) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, maintains 4 additional practice locations, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 4
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
Brandi Wallace 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 Reassignments
2Medicare enrollment records show Brandi Wallace reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fargo, ND 58104
- Reassigned Medicare billing, Minnesota and North Dakota enrollments
- 87 clinicians in this Medicare group
Lakeville, MN 55044
- Reassigned Medicare billing, North Dakota enrollment
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 58104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Brandi Wallace's NPI number?
The NPI number for Brandi Wallace is 1982739900. It was assigned to this individual provider in the NPPES registry on February 22, 2007.
Where is Brandi Wallace located?
Brandi Wallace practices at 4622 40th Avenue South Suite A, Fargo, ND 58104. The listed phone number is (701) 364-2909.
What is Brandi Wallace's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Brandi Wallace enrolled in Medicare?
Yes. Brandi 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 organizations bill Medicare for Brandi Wallace's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brandi Wallace reassigns Medicare benefits to 2 organizations: Innovis Health LLC (Fargo, ND) and Marciana Group (Lakeville, MN). 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 Brandi Wallace's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Brandi Wallace accept?
Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Brandi 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.
When was this NPI record last updated?
The NPPES record for Brandi Wallace was last updated on October 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Brandi Wallace, FNP · NPI 1982739900
Family physician in Fargo, North Dakota. Individual provider, active in the CMS NPPES registry since February 22, 2007.
## Identity
- **NPI:** 1982739900 (Entity type: Individual)
- **Enumerated:** February 22, 2007
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** R30131 (North Dakota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4622 40TH AVENUE SOUTH, SUITE A, Fargo, ND 58104-4394
- **Phone:** (701) 364-2909
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Innovis Health LLC (NPI 1144776576, Fargo, ND); Marciana Group (NPI 1134719693, Lakeville, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** October 25, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1982739900) · Data from the CMS NPPES public registry.