Individual provider Active NPI

Kimberly M Weier, PA-C

  • Physician Assistant
  • Auburn, NY
National Provider Identifier
1710609631
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029180 Issued in NY
Practice address
77 Nelson St Ste 240
Auburn, NY 13021-1944
Phone
(315) 567-0390
NPI assigned
Sep 16, 2022
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029180 NY Primary

Addresses

Primary practice location

77 Nelson St Ste 240
Auburn, NY 13021-1944

Mailing address

17 Lansing St
Auburn, NY 13021-1983

Other names 1

  • Kimberly M Wallach Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221110000418 NY Practitioner - Physician Assistant 9537536156 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

37 W Garden St
Auburn, NY 13021-2657

77 Nelson St
Auburn, NY 13021-1941

77 Nelson St
Auburn, NY 13021-1944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.56 of 100Reported as group
Quality
71.97
Promoting interoperability
100
Improvement activities
40
Cost
75.04

Merit-based Incentive Payment System (MIPS)

Final score
75.68 of 100Reported as group
Quality
48.88
Promoting interoperability
91
Improvement activities
40
Cost
71.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in CurrentSince Oct 18, 2022 Accepting new patients
Auburn Community Hospital CurrentSince Sep 1, 2024 Accepting new patients
Department of Medicine Medical Service Group CurrentSince Oct 18, 2022 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

77 Nelson St
Ste 240
Auburn, NY 13021
Phone (315) 252-0810

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

3229 E Genesee St
Syracuse, NY 13214
Phone (315) 446-7501

725 E Adams St
Syracuse, NY 13210
Phone (315) 464-4357

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1710609631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NELSON ST STE 240",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211944",
            "telephone_number": "315-567-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIER",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WALLACH",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.