Kimberly Ann Bollmeier, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3083-23 Issued in WI

Practice address

8501 75TH St Ste J
Kenosha, WI 53142-7602

Phone

(262) 697-8030

Fax

(262) 697-6157

NPI assigned

Apr 23, 2012

Last updated

Aug 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Ann Wagner Other name

Electronic endpoints 4

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, 2011

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.bollmeier@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Appleton, WI
  • NPI 1083768253
  Medicare reassignment Care Compare group
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Oconomowoc, WI
  • NPI 1023482569
  NPD
• Forefront Dermatology, S.C.

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

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)
• Des Plaines Dermatology, LTD.

  • Dermatology Physician
  • Des Plaines, IL
  • NPI 1902127194
  NPD (past)

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1598023939",
    "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": "8501 75TH ST STE J",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427602",
            "telephone_number": "262-697-8030",
            "fax_number": "262-697-6157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9020 76th St Ste E",
            "address_purpose": "LOCATION",
            "city": "Pleasant Prairie",
            "state": "WI",
            "postal_code": "531581976",
            "country_code": "US",
            "telephone_number": "262-697-8030",
            "fax_number": "262-697-6157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1245 Cheyenne Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Grafton",
            "state": "WI",
            "postal_code": "530249323",
            "country_code": "US",
            "telephone_number": "262-377-2222",
            "fax_number": "262-377-6543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLMEIER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004647",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3083-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Bollmeier@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "8501 75th St Ste J",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531427602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Bollmeier@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "9020 76th St Ste E",
            "city": "Pleasant Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531581976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Bollmeier@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "7200 Washington Ave",
            "address_2": "Suite 100",
            "city": "MT Pleasant",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534066516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Bollmeier@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1245 Cheyenne Ave Ste 301",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WAGNER",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robbi Bode
• Hannah Bodnar, DPT
• Kerrie Boeckman
• Karla S. Boho, N.P.
• Kelsey Lynn Bohr, NP
• Louise A Borst, RPH CGP
• Brienna Marie Bostanche, DPM
• John L Bostanche, D.P.M.
• Brian Daniel Boston, DMD
• Rommel Ortiz Bote', M.D.

• Physician Assistant in Kenosha, WI
• Providers in Kenosha, 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 15, 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.