DONNETTA LYNN WALLACE – Family Nurse Practitioner, NPI 1922436914
Family Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,720 NURSE PRACTITIONER in MN
Provider Addresses for DONNETTA LYNN WALLACE
1700 HIGHWAY 25 N
BUFFALO, MN 553131930
Phone: (763) 684-3678
Fax: (763) 684-3790
Type: Location
1700 Highway 25 N
Buffalo, MN 553131930
Phone: (763) 684-3678
Fax: (763) 684-3790
Type: Location
1001 HART BLVD STE 100
MONTICELLO, MN 553628929
Phone: (763) 295-2921
Fax: (763) 581-9090
Type: Location
11091 JASON AVE NE
ALBERTVILLE, MN 553014699
Phone: (763) 684-8300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-12-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131217001429 | I | Nurse Practitioner | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 79 | 39 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 77 | 39 | $0 |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 53 | 32 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 35 | 26 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 21 | $0 |
Insurance plans in this area (ZIP 55313)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MN | |
| Internal Medicine | MN | |
| Family Practice | MN | |
| Certified Nurse Midwife (Cnm) | MN | |
| Family Practice | MN | |
| Family Practice | MN | |
| Family Practice | MN | |
| Nurse Practitioner | MN | |
| Family Practice | MN | |
| Physician Assistant | MN |
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