NPIMap

Individual provider Active NPI

Kimberley Alexandria Wilson, NP

  • Adult Health Nurse Practitioner
  • Buffalo, NY
National Provider Identifier
1033432893
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
30305333 Issued in NY
Practice address
300 Niagara St
Buffalo, NY 14201-2135
Phone
(716) 859-5600
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 30305333 NY Primary
Women's Health Nurse Practitioner 363LW0102X 42420977 NY

Addresses

Primary practice location

300 Niagara St
Buffalo, NY 14201-2135

Mailing address

78 Raintree Is
Apt #8
Tonawanda, NY 14150-9539
Phone (716) 289-5608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131009002100 NY Practitioner - Nurse Practitioner 0749414514 Reassigns benefits to 2 organizations
I20250918002164 NC Practitioner - Nurse Practitioner 0749414514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1021 Morehead Medical Dr
Suite a
Charlotte, NC 28204-2990
Phone (980) 442-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30305333NYMDAdult Health Nurse Practitioner
42420977NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 16, 2025 Accepting new patients
Kaleida Health CurrentSince Oct 1, 2013 Accepting new patients
Brain & Spine Medical Services PLLC CurrentSince Apr 1, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Dia Invision Health CurrentSince Apr 1, 2020 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Jun 16, 2025 Accepting new patients
Kaleida Health CurrentSince Oct 1, 2013 Accepting new patients

Locations

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

100 Medical Park Dr
Ste 110
Concord, NC 28025
Phone (704) 403-1370

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

300 Niagara St
Buffalo, NY 14201
Phone (716) 242-8600

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

400 International Dr
Williamsville, NY 14221
Phone (716) 631-1516

Interoperability endpoints

  • Direct secure messaging: kwilson3007641@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1033432893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 RAINTREE IS",
            "address_2": "APT #8",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509539",
            "telephone_number": "716-289-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142012135",
            "telephone_number": "716-859-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KIMBERLEY",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "30305333",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "42420977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.