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

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: October 18, 2026.

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

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Wise reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Suny Health Science Center At Syracuse
Same address
General Acute Care Hospital
750 EAST ADAMS STREET
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 271 clinicians in this Medicare group
NPI 1184974529 (315) 464-6530

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 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.

Other Providers at the Same Location NPPES 20

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

SARAH BOWLER PA
Physician Assistant
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-1800
DR. CARLOS F MUNIZ MD
Psychiatry & Neurology (Neurology)
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-4627
DR. LEAH M BENNETT MD
Emergency Medicine
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-4363
LAINEY A BROWN PA
Physician Assistant
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-5774
DR. DEVIN J. BURKE MD
Psychiatry & Neurology (Neurocritical Care)
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-4627
ALLISON CARBERY NP
Nurse Practitioner (Family)
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-3510
MS. SARAH E HARDING
Pediatrics (Pediatric Critical Care Medicine)
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-5450
MRS. CHRISTINE ANN LOPEZ-DWYER NP
Nurse Practitioner (Pediatrics)
750 EAST ADAMS STREET
SYRACUSE, NY 13210
Onondaga County (315) 464-9334

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 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.

Where is Kimberly Wise located?

Kimberly Wise practices at 750 East Adams Street, Syracuse, NY 13210. The listed phone number is (315) 464-5450.

What is Kimberly Wise's specialty?

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

Is Kimberly Wise enrolled in Medicare?

Yes. Kimberly Wise is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Wise's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Wise reassigns Medicare benefits to Suny Health Science Center At Syracuse (Syracuse, NY). 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 Kimberly Wise's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Wise was last updated on May 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.