Nicole Anissa Kujawa, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1015-23 Issued in WI

Practice address

1320 Pabst Farms Cir Unit 180
Oconomowoc, WI 53066-4878

Phone

(262) 560-0322

Fax

(262) 560-0379

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole A Claus Pino Former name

Electronic endpoints 2

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, 1997

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)

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.kujawa@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
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • De Pere, WI
  • NPI 1588857247
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1699588145
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1174628341",
    "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": "1320 PABST FARMS CIR UNIT 180",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664878",
            "telephone_number": "262-560-0322",
            "fax_number": "262-560-0379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16455 W Bluemound Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055921",
            "country_code": "US",
            "telephone_number": "262-784-7820",
            "fax_number": "262-784-7936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUJAWA",
        "first_name": "NICOLE",
        "middle_name": "ANISSA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1015-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicole.Kujawa@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1320 Pabst Farms Cir Unit 180",
            "city": "Oconomowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nicole.Kujawa@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "16455 W Bluemound Rd",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530055921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CLAUS PINO",
            "middle_name": "A",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kpi,Inc
• Wendy Kraemer, RN
• Mitzi Montgomery Kramer, M.D.
• Ann M Kratzer, LPC
• Susanc Kuerschner, LPN
• Olivia Jill Kulaszewicz, PHARMD
• Emily Kulpa, PHARMD
• Gerard L. Kupperman, PH.D.
• Lake Area Free Clinic
• Lake Country Birth LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.