Kimberly Elizabeth Wysocki, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

37304 Kings Hwy
Beaver Island, MI 49782-5134

Phone

(231) 448-2275

NPI assigned

Jun 12, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaver Island Rural Health CenterGroup PAC ID 3971539156, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Beaver Island Rural Health Center

  • Rural Health Clinic/Center
  • Beaver Island, MI
  • NPI 1407828080
  Medicare reassignment Care Compare group
• LMT Rehabilitation Associates

  • Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
  • Rochester Hills, MI
  • NPI 1093933806
  NPD (past)
• Orchardview Physicians

  • Urgent Care Clinic/Center
  • Washington Township, MI
  • NPI 1649435256
  NPD (past)
• Pennock Hospital

  • Family Medicine Physician
  • Hastings, MI
  • NPI 1518186295
  NPD (past)

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

• Munson Healthcare Charlevoix Hospital

  • Critical Access Hospital
  • Charlevoix, MI
  • NPI 1346260692
  Care Compare affiliation

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1275760639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37304 KINGS HWY",
            "city": "BEAVER ISLAND",
            "state": "MI",
            "postal_code": "497825134",
            "telephone_number": "231-448-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37304 KINGS HWY",
            "city": "BEAVER ISLAND",
            "state": "MI",
            "postal_code": "497825134",
            "telephone_number": "231-448-2275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52349 Forest Grv",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483152316",
            "country_code": "US",
            "telephone_number": "586-909-0148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "KIMBERLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Deruiter, RDH
• Amanda Tiffany McGee, NP-C
• Susan Jane Solle, FNPC
• Scott Spencer
• Wendy Sue White, DDS

• Physician Assistant in Beaver Island, MI
• Providers in Beaver Island, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.