Kimberly Joy Waack, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2026-0045 Issued in NM

Practice address

1901 Juan Tabo Blvd NE Ste B
Albuquerque, NM 87112-3303

Phone

(505) 281-5180

Fax

(505) 702-8171

NPI assigned

Jun 22, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Joy Hardwick Former name

Medicare fee-for-service enrollment

Enrolled in NC, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwaack494499@directhisp.wakemed.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• McLeod Medical Centers of NM, Inc.

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1700393782
  Medicare reassignment
• Cancer Care Northwest Centers P S

  • Hematology & Oncology Physician
  • Spokane Valley, WA
  • NPI 1922072081

  Physician Assistant

  NPD
• David Paul Adams MD PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1447336003
  NPD (past)
• Raleigh Durham Medical Group PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1295784874
  NPD (past)
• Wake Specialty Physicians LLC

  • Family Medicine Physician
  • Morrisville, NC
  • NPI 1174491138
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1023214566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "877-498-4490",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 JUAN TABO BLVD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123303",
            "telephone_number": "505-281-5180",
            "fax_number": "505-702-8171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2216 E Nc Highway 54",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277132208",
            "country_code": "US",
            "telephone_number": "919-350-0365",
            "fax_number": "919-235-1307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAACK",
        "first_name": "KIMBERLY",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2026-0045",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HARDWICK",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zao Charles Vu, MD
• Duc C Vuong, M.D.
• Mimi Vuong
• Indravadan Vyas, MD
• W Gregory Rose DDS PA
• Richard A. Wachs, M.D.
• David Wachter, MD
• Meredith J Wachter
• William Wackocki
• Jessica Marie Waconda

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.