Nicholas Patrick Grimm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2166-023 Issued in WI

Practice address

3515 Murray St
Marinette, WI 54143-3367

Phone

(715) 732-0699

Fax

(715) 732-3522

NPI assigned

Jun 29, 2007

Sex

Male

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.grimm@forefrontdermatology.emadirect.md

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Appleton, WI
  • NPI 1083768253
  Medicare reassignment Care Compare group
• Baycare Clinic LLP

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1588609648
  Medicare reassignment NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Marinette, WI
  • NPI 1417105545
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

• Aurora Medical Center Bay Area, Inc

  • General Acute Care Hospital
  • Marinette, WI
  • NPI 1043397177
  Care Compare affiliation
• Aurora Medical Center Bay Area, Inc

  • Clinical Medical Laboratory
  • Marinette, WI
  • NPI 1083791115

  Hospital

  Care Compare affiliation
• Aurora Medical Center Bay Area, Inc

  • Land Ambulance
  • Marinette, WI
  • NPI 1427135557

  Hospital

  Care Compare affiliation
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1104023381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 MURRAY ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433367",
            "telephone_number": "715-732-0699",
            "fax_number": "715-732-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N4531 State Highway 22 Ste 5",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541666173",
            "country_code": "US",
            "telephone_number": "715-524-5995",
            "fax_number": "715-953-4257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Superior Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543117595",
            "country_code": "US",
            "telephone_number": "920-406-9803",
            "fax_number": "920-406-9934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "NICHOLAS",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2166-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2166-023",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicholas.Grimm@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3515 Murray St",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicholas.Grimm@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "715 Superior Rd Ste 120",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543117595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicholas.Grimm@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "N4531 State Highway 22 Ste 5",
            "city": "Shawano",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541666173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline A Gouge, APNP
• Erik K Graglia, OCCUPATIONAL THERAPI
• Alison Granquist, LCSW
• Great Blue Dental, LLC
• Great Lakes Heart and Vascular, LLC
• Brianna Grosso
• Terri Lynn Grun, LPN
• Melissa Guay, BSN, RN
• Adam Mehmet Gulhan, MD
• Andrea Gundelach, CRNA

• Physician Assistant in Marinette, WI
• Providers in Marinette, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.