Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Joy Waack, PA-C

Individual provider Physician Assistant · NPI 1023214566

Kimberly Joy Waack, PA-C is a Physician Assistant in Albuquerque, New Mexico. Qualified in 2006, 20 years ago. Practices with Wake Specialty Physicians LLC, a 178-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and New Mexico.

Years since qualifying
20
Licensed in
NC, NM
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1901 Juan Tabo Blvd NE Ste B
Albuquerque, NM 87112-3303
Phone: (505) 281-5180
Fax: (505) 702-8171
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2216 E Nc Highway 54, Durham, NC 27713-2208 — (919) 350-0365

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA2026-0045 (NM)
Physician Assistant Taxonomy 363A00000X · Licence 0010-00955 (NC)

Record details

NPI number1023214566
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 22, 2007
Last updated in NPPESMay 26, 2026
Certification dateMay 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Wake Specialty Physicians Llc — 178 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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