| Kimberly Joy Waack, PA-C | |
|
1901 Juan Tabo Blvd Ne Ste B, Albuquerque, NM 87112-3303 | |
| (505) 281-5180 | |
| (505) 702-8171 |
| Full Name | Kimberly Joy Waack |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 1901 Juan Tabo Blvd Ne Ste B, Albuquerque, New Mexico |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023214566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA2026-0045 (New Mexico) | Primary |
| 363A00000X | Physician Assistant | 0010-00955 (North Carolina) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wakemed | Raleigh, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wake Specialty Physicians Llc | 7416006085 | 178 |
| Entity Name | Wake Specialty Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942440375 PECOS PAC ID: 7416006085 Enrollment ID: O20090601000520 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Joy Waack, PA-C Po Box 602195, Charlotte, NC 28260-2195 Ph: (877) 498-4490 | Kimberly Joy Waack, PA-C 1901 Juan Tabo Blvd Ne Ste B, Albuquerque, NM 87112-3303 Ph: (505) 281-5180 |
Audra Dawn Clemens, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1100 Central Ave Se, Albuquerque, NM 87106 Phone: 505-724-6124 Fax: 505-724-6125 |
Jessica Rose Aragon, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 5904 Holly Ave Ne, Albuquerque, NM 87113 Phone: 505-298-2505 |
Elise Nicole Pedigo, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 630 Haines Ave Nw, Albuquerque, NM 87102 Phone: 505-268-5611 Fax: 505-268-5736 |
Samantha Travierso, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1501 San Pedro Dr Se, Albuquerque, NM 87108 Phone: 505-265-1711 |
Mrs. Danielle Kimberly Mccarthy, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 8301 Spain Rd Ne, Albuquerque, NM 87109 Phone: 505-821-6663 |
Ms. Lauren Soules, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3615 Highway 528 Nw, Albuquerque, NM 87114 Phone: 505-248-1518 |
Jennifer Lynn Otis, Physician Assistant Medicare: Medicare Enrolled Practice Location: 3741 Rutledge Rd Ne, Albuquerque, NM 87109 Phone: 505-798-9300 Fax: 505-798-0808 |