Kimberly Joy Waks, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5498 Issued in CT

Practice address

2800 Main Street
Bridgeport, CT 06606

Phone

(203) 382-2350

Fax

(475) 210-3025

NPI assigned

Jan 12, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent's Medical Center Hospital, Bridgeport, CT, CCN 070028
• Midstate Medical Center Hospital, Meriden, CT, CCN 070017

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

83.36

Promoting interoperability

100

Improvement activities

40

Cost

75.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.waks@xdr.hhchealthdirect.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.

• Hartford Healthcare Medical Group Specialists, PLLC

  • Surgery Physician
  • Hartford, CT
  • NPI 1023584216
  Medicare reassignment Care Compare group NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment Care Compare group NPD
• Connecticut Mental Health Specialists Inc

  • Psychiatry Physician
  • Farmington, CT
  • NPI 1053362814
  Medicare reassignment
• Rushford Center, Inc.

  • Psychologist
  • Meriden, CT
  • NPI 1275541005
  Medicare reassignment
• Hartford Healthcare Medical Group Specialists LLC

  • Customized Equipment (DME)
  • Groton, CT
  • NPI 1295367068
  NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD
• Spine and Pain Institute at Midstate LLC

  • Interventional Pain Medicine Physician
  • Meriden, CT
  • NPI 1033488119
  NPD (past)
• Meridian Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Hagerstown, MD
  • NPI 1528680865
  NPD (past)

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

• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  Care Compare affiliation
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1669524187
  Care Compare affiliation
• SVMC Holdings, Inc

  • General Acute Care Hospital
  • Bridgeport, CT
  • NPI 1942224696
  Care Compare affiliation

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

{
    "created_epoch": "1547251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1235603259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-382-2350",
            "fax_number": "475-210-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-382-2350",
            "fax_number": "475-210-3025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Retreat Ave Ste 900",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061062553",
            "country_code": "US",
            "telephone_number": "860-218-2245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 Caledon Ct Apt 12",
            "address_purpose": "LOCATION",
            "city": "Stephens City",
            "state": "VA",
            "postal_code": "226553547",
            "country_code": "US",
            "telephone_number": "516-306-2353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAKS",
        "first_name": "KIMBERLY",
        "middle_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-12",
        "last_updated": "2024-05-24",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "5498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Paris Wade, MD
• Katherine M Wagner-Reiss, M.D.
• Amanda Wagner, APRN, CRNA
• Anja Wagner, MD
• Michael Geoffrey Wagner, DO
• Waldbaum Inc (A and P Superfoodmart Pharmacy)
• Walgreen Co (Walgreens #07522)
• Walgreen Co (Walgreens Specialty Pharmacy #16548)
• Walgreen Co (Walgreens #09521)
• Walgreen Co (Rite Aid #20894)

• Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.