Individual provider Active NPI

Kelly Michele Wilmas, MD

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1972008290
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2023014180 Issued in MO
Practice address
12855 N 40 Dr Ste 180
Saint Louis, MO 63141-8657
Phone
(314) 878-5599
Fax
(314) 392-4290
NPI assigned
Mar 28, 2018
Last updated
Jul 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01097954A IN
Dermatology Physician 207N00000X 2023014180 MO Primary
MOHS-Micrographic Surgery Physician 207ND0101X 01097954A IN
MOHS-Micrographic Surgery Physician 207ND0101X 2023014180 MO

Addresses

Primary practice location

12855 N 40 Dr Ste 180
Saint Louis, MO 63141-8657

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

4020 New Vision Dr
Fort Wayne, IN 46845-1737
Phone (260) 423-2567

Other practice location 2

130 Richardson Xing Ste 130
Arnold, MO 63010-6023
Phone (636) 489-4770

Other practice location 3

1223 Maple St
Farmington, MO 63640-7616
Phone (573) 760-0091

Other practice location 4

70 W 94th Pl
Crown Point, IN 46307-1710
Phone (219) 662-8822

Other practice location 5

8567 Watson Rd Ste A
Webster Groves, MO 63119-5251
Phone (314) 528-9040

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md
Direct Messaging Address Kelly.Wilmas@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230515000280 MO Practitioner - Dermatology 2769869353 Reassigns benefits to 1 organization
I20251025000108 IN Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2769869353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, shared by 26 NPIs, 650 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 180
Saint Louis, MO 63141-8657
Phone (314) 878-5599

4020 New Vision Dr
Fort Wayne, IN 46845-1737
Phone (260) 423-2567

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision112
Removal of skin lesions85
Removal of skin cancer660
Removal or shaving of skin growth1-10
Skin biopsy20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01097954AINMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jul 1, 2023 Accepting new patients
Forefront Dermatology SC Dermatology CurrentSince Oct 20, 2025 Accepting new patients
St. Louis Dermatology and Surgery Center, PC Mohs-Micrographic Surgery Current Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jul 1, 2023 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

70 W 94th Pl
Crown Point, IN 46307
Phone (219) 662-8822

7516 Eagle Crest Blvd
Ste D
Evansville, IN 47715
Phone (812) 401-8999

4020 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 423-2567

303 S Walnut St
Seymour, IN 47274
Phone (812) 358-7705

130 Richardson Xing
Ste 130
Arnold, MO 63010
Phone (636) 489-4770

1223 Maple St
Farmington, MO 63640
Phone (573) 760-0091

12855 N 40 Dr
Ste 180
Saint Louis, MO 63141
Phone (314) 878-5599

8567 Watson Rd
Ste A
Webster Groves, MO 63119
Phone (314) 528-9040

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: kelly.wilmas@forefrontdermatology.emadirect.md

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1972008290",
    "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": "12855 N 40 DR STE 180",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-878-5599",
            "fax_number": "314-392-4290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4020 NEW VISION DR",
            "address_purpose": "LOCATION",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451737",
            "country_code": "US",
            "telephone_number": "260-423-2567",
            "fax_number": "260-420-2415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Richardson Xing Ste 130",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MO",
            "postal_code": "630106023",
            "country_code": "US",
            "telephone_number": "636-489-4770",
            "fax_number": "636-489-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1223 Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636407616",
            "country_code": "US",
            "telephone_number": "573-760-0091",
            "fax_number": "573-760-8844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 W 94th Pl",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463071710",
            "country_code": "US",
            "telephone_number": "219-662-8822",
            "fax_number": "219-662-8833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8567 Watson Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Webster Groves",
            "state": "MO",
            "postal_code": "631195251",
            "country_code": "US",
            "telephone_number": "314-528-9040",
            "fax_number": "314-528-9041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILMAS",
        "first_name": "KELLY",
        "middle_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01097954A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2023014180",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IN",
            "license": "01097954A",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2023014180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "4020 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "70 W 94th Pl",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463071710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "8567 Watson Rd Ste A",
            "city": "Webster Groves",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631195251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1223 Maple St",
            "city": "Farmington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636407616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "130 Richardson Xing Ste 130",
            "city": "Arnold",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630106023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly.Wilmas@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "12855 N 40 Dr Ste 180",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631418657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.