Kimberly L. Waller, PA-C
NPI 1093782914ActiveIndividual· Physician Assistant· Grants Pass, OR
Physician Assistant (PA-C) with Siskiyou Community Health Center Inc, practicing in Grants Pass, Oregon. Their prescriptions cost Medicare Part D more than their services did: $1,195,783 for 2,341 claims, against $1,859 paid for services in 2024. Lists Asante Three Rivers Medical Center and 3 other hospitals as hospital affiliations.
Overview
| NPI | 1093782914 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Mar 1, 2006 |
| Last updated in NPPES | Oct 28, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA01142 | OR |
| Physician Assistant, Medical | 363AM0700X | PA842 | NV |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 46 |
|---|---|
| Services billed | 215 across 10 procedure codes |
| Paid by Medicare | $1,859 |
Part D prescriptions in 2024
| Prescriptions (claims) | 2,341 · 4,374 30-day fills |
|---|---|
| Patients | 249 |
| Total drug cost | $1,195,783 |
| Generic share | 20% of claims |
Education and affiliations
| Graduation year | 1997 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Siskiyou Community Health Center IncGrants Pass, OR · 30 clinicians
Hospital affiliations
- Asante Three Rivers Medical CenterGrants Pass, OR
- Curry General HospitalGold Beach, OR
- Mercy Medical CenterRoseburg, OR
- Sutter Coast HospitalCrescent City, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 43 physician assistants in Grants Pass · All physician assistants in Oregon