KIMBERLY WISE NP
NPI 1124663521
Nurse Practitioner - Pediatrics in Syracuse, NY

Q: What is Kimberly Wise's NPI number?

The NPI number for Kimberly Wise is 1124663521. It was assigned to this individual provider in the NPPES registry on November 10, 2019.

Q: What is Kimberly Wise'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 Kimberly Wise was last updated on May 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 10, 2019PECOS Enrolled

750 EAST ADAMS STREET, SYRACUSE, NY 13210(315) 464-5450(315) 464-6322 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 28, 2020, Dec 11, 2019, Nov 10, 2019 (3 updates tracked since 2019).

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About Kimberly Wise Np NPPES

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

KIMBERLY WISE NP (NPI 1124663521) is an individual pediatrics provider in Syracuse, New York, licensed in New York (382971) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124663521

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameKIMBERLY WISECredential: NP

Location Address750 EAST ADAMS STREETSyracuse, NY 13210

Mailing Address251 Salina Meadows Parkway, Suite 100Syracuse, NY 13212 · (315) 464-2000 · Fax (315) 464-2010

Phone(315) 464-5450

Fax(315) 464-6322

Sole ProprietorNo

Enumeration DateNovember 10, 2019

Last NPPES UpdateMay 28, 20243 updates tracked since enumeration

NPPES CertifiedJanuary 28, 2020

✔ NPI 1124663521 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

Licenses✔ Licensed in NY · 382971✔ Licensed in MA · RN233955✔ Licensed in MA · RN2332955

750 EAST ADAMS STREET, Syracuse, NY 13210

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Wise Np 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 13210 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

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