Kimberly Lynn Wile, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA59724 Issued in CA

Practice address

4077 Fifth Ave
San Diego, CA 92103-2105

Phone

(619) 686-3935

NPI assigned

Jul 6, 2021

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

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Scripps Health Inpatient Providers Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1699043000
  Medicare reassignment Care Compare group
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  NPD

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

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1174194641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-686-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 FIFTH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "619-686-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILE",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "PA59724",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Paul Wilde, D.M.D.
• Joshua Zachary Wilde, D.O.
• Kanoni Wilder
• Michael L. Wilder, MD
• Yavonie Wildman
• Peter Bartholomew Wile, M.D.
• Jonathan Seth Wilensky, MD
• Katrina Wiles, MS, OTR/L
• Crystal N Wiley Cene, M.D.
• Syranda Faith Wiley de Navarro, M.S.

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.