KAILYN WIERSMA
NPI 1508393976
Pediatrics in Meridian, ID

Q: What is Kailyn Wiersma's NPI number?

The NPI number for Kailyn Wiersma is 1508393976. It was assigned to this individual provider in the NPPES registry on May 17, 2017.

Q: What is Kailyn Wiersma's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kailyn Wiersma was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 17, 2017PECOS Enrolled

1620 S CELEBRATION AVE, MERIDIAN, ID 83642(208) 884-1030 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 14, 2022, Jun 15, 2020, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Kailyn Wiersma NPPES

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

KAILYN WIERSMA (NPI 1508393976) is an individual pediatrics provider in Meridian, Idaho, licensed in Idaho (M-16194) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1508393976

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameKAILYN WIERSMA

Location Address1620 S CELEBRATION AVEMeridian, ID 83642-2779

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 884-1030

Sole ProprietorNo

Enumeration DateMay 17, 2017

Last NPPES UpdateApril 14, 20224 updates tracked since enumeration

NPPES CertifiedApril 14, 2022

✔ NPI 1508393976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in ID · M-16194✔ Licensed in MI · 4301501833✔ Licensed in MI · 4301112092

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1620 S CELEBRATION AVE, Meridian, ID 83642

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Secondary Practice Locations 2

Location 11500 E Medical Center Dr Spc 5718Ann Arbor, MI 48109-5718 · Phone (734) 763-5589 · Fax (734) 763-4208

Location 2200 Arnet StYpsilanti, MI 48198-5753 · Phone (734) 484-7288

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kailyn Wiersma 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 Kailyn Wiersma reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Lukes Clinic-Treasure Valley LLC

8.9 mi

Family Medicine

190 E BANNOCK ST
Boise, ID 83712

Reassigned Medicare billing, Idaho enrollment
1,312 clinicians in this Medicare group

NPI 1326336058 (208) 381-2222

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 83642 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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 13

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

JOSHUA EDWIN ALBRIGHT

Pediatrics