| Ms Nicole Anissa Kujawa, PA | |
|
1320 Pabst Farms Cir Unit 180, Oconomowoc, WI 53066-4878 | |
| (262) 560-0322 | |
| (262) 560-0379 |
| Full Name | Ms Nicole Anissa Kujawa |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 29 Years |
| Location | 1320 Pabst Farms Cir Unit 180, Oconomowoc, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174628341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 1015-23 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Forefront Dermatology Sc | 3779471701 | 650 |
| Entity Name | Forefront Dermatology SC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083768253 PECOS PAC ID: 3779471701 Enrollment ID: O20040310000252 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Nicole Anissa Kujawa, PA 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | Ms Nicole Anissa Kujawa, PA 1320 Pabst Farms Cir Unit 180, Oconomowoc, WI 53066-4878 Ph: (262) 560-0322 |
Thomas Ruffalo, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 791 Summit Ave, Oconomowoc, WI 53066 Phone: 262-569-9119 |
Karen Maurer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1185 Corporate Center Dr Ste 300, Oconomowoc, WI 53066 Phone: 888-938-3838 Fax: 888-919-1083 |
Tamara Grissman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1284 N Summit Ave, Oconomowoc, WI 53066 Phone: 262-560-3700 Fax: 262-560-3759 |
Catherine D Keulks-torinus, P.A.C. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 791 E Summit Ave, Oconomowoc, WI 53066 Phone: 262-569-0251 Fax: 262-569-0342 |
Rick Woodward, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 34700 Valley Rd, Oconomowoc, WI 53066 Phone: 800-767-4411 |
Amber C Mayo, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 791 E Summit Ave, Oconomowoc, WI 53066 Phone: 262-569-0251 Fax: 262-569-0342 |
Mason Nelson, Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1417 Altis Dr Unit 207, Oconomowoc, WI 53066 Phone: 218-530-0035 |