MRS. KIMBERLY ELIZABETH WYSOCKI (PA) – Physician Assistant, NPI 1275760639

MRS. KIMBERLY ELIZABETH WYSOCKI (PA) is a healthcare provider. based in Shelby twp, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for MRS. KIMBERLY ELIZABETH WYSOCKI (PA) is 1275760639

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY ELIZABETH WYSOCKI (PA)
NPI
1275760639
Phone
(586) 909-0148
Address
52349 FOREST GRV
Enumeration Date
12 June 2009
Last Update Date
15 July 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2314482275
Graduation Year
2009 (17 years ago)
PAC ID
6406902584
Group Practice PAC ID
3971539156
Professional Enrollment ID
I20090914000788
Address ID
MI497825134BE37304HWYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:16State licenses:0Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for MRS. KIMBERLY ELIZABETH WYSOCKI (PA)

  • 52349, Forest Grove, Birchfield Sub, Shelby Charter Township, Macomb County, Michigan, 48315, United States

    SHELBY TWP, MI 483152316

    Phone: (586) 909-0148

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-07-25 • Largest payer in this snapshot: ABBVIE INC. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-25

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$19
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-09-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090914000788IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48315)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971539156View full group profile
NameSpecialtyState
Pain ManagementIN
Nurse PractitionerMI
Family PracticeMI
Clinical PsychologistMI
Nurse PractitionerMI
-MI
Nurse PractitionerMI
Orthopedic SurgeryMI

Reviews

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Frequently asked questions

What number should I use to identify MRS. KIMBERLY ELIZABETH WYSOCKI (PA) for billing?
Administrative and clinical systems typically use NPI 1275760639 for MRS. KIMBERLY ELIZABETH WYSOCKI (PA).
Is MRS. KIMBERLY ELIZABETH WYSOCKI (PA)'s NPI status active today?
Active status means MRS. KIMBERLY ELIZABETH WYSOCKI (PA)'s NPI record is not deactivated in the public file.
Which specialty label fits MRS. KIMBERLY ELIZABETH WYSOCKI (PA)?
NPPES ties MRS. KIMBERLY ELIZABETH WYSOCKI (PA) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. KIMBERLY ELIZABETH WYSOCKI (PA)?
MRS. KIMBERLY ELIZABETH WYSOCKI (PA) is associated with Shelby Twp, Michigan in the same public data insurers reference.
Can I export MRS. KIMBERLY ELIZABETH WYSOCKI (PA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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