Individual provider Active NPI

Kathy Lynn Wirz, CNP

  • Nurse Practitioner
  • Espanola, NM
National Provider Identifier
1417514712
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
57115 Issued in NM
Practice address
1010 Spruce St
Espanola, NM 87532-2724
Phone
(518) 481-8000
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019014886 MO
Nurse Practitioner 363L00000X 57115 NM Primary
Nurse Practitioner 363L00000X 345173 NY

Addresses

Primary practice location

1010 Spruce St
Espanola, NM 87532-2724

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666
Phone (573) 923-6770

Other practice location 1

75 Beekman St
Plattsburgh, NY 12901-1427
Phone (518) 561-2000

Other practice location 2

45 6th St
Malone, NY 12953-1247
Phone (573) 481-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, 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

Enrollment IDStateProvider typePAC IDDetails
I20191205000142 NY Practitioner - Nurse Practitioner 4385077361 Reassigns benefits to 2 organizations
I20201007003031 NM Practitioner - Nurse Practitioner 4385077361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1010 Spruce St
Espanola, NM 87532-2724
Phone (505) 367-0360

Hospital & facility affiliations

  • Mountain Home Health Care, Inc. Home health agency, Taos, NM, CCN 327010
  • Ambercare Home Health Home health agency, Belen, NM, CCN 327123
  • Presbyterian Espanola Hospital Hospital, Espanola, NM, CCN 320011
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57115NMMDNurse Practitioner
345173NYMDNurse Practitioner
2019014886MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Nov 9, 2020 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Nurse Practitioner CurrentSince Jul 1, 2020 Accepting new patients
Alice Hyde Medical Center Nurse Practitioner CurrentSince Oct 15, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 9, 2020 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Alice Hyde Medical Center Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Fl 2
Espanola, NM 87532
Phone (505) 367-0340

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

45 6th St
Malone, NY 12953
Phone (518) 481-8000

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

Interoperability endpoints

  • Direct secure messaging: kwirz187048@direct.phs.org

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 5

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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1417514712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "573-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SPRUCE ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322724",
            "telephone_number": "518-481-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011427",
            "country_code": "US",
            "telephone_number": "518-561-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 6th St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531247",
            "country_code": "US",
            "telephone_number": "573-481-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIRZ",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019014886",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "57115",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "345173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

Verify at the official NPI Registry.