KELSEY GRIMMER (PA) – Medical Physician Assistant, NPI 1265695530

KELSEY GRIMMER (PA) is a healthcare provider. based in Lake forest, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2303 (WI). The NPI Number for KELSEY GRIMMER (PA) is 1265695530

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY GRIMMER (PA)
NPI
1265695530
Phone
(920) 791-1347
Address
900 N WESTMORELAND RD
Enumeration Date
8 July 2008
Last Update Date
19 February 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7732963636
Graduation Year
2008 (18 years ago)
PAC ID
4880769579
Group Practice PAC ID
9537128004
Professional Enrollment ID
I20180919002111
Address ID
IL606575190CH3000XSTXX408
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:17State licenses:2Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for KELSEY GRIMMER (PA)

  • 900, North Westmoreland Road, Deerpath, Lake Forest, Lake, Illinois, 60045, United States

    STE 222

    LAKE FOREST, IL 600451674

    Phone: (920) 791-1347

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 205 Open Payments records for all available years, with a total value of $4,882.

Total Amount is formed as General ($4,882) + Research ($0) + Ownership ($0) = $4,882.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Janssen Biotech, Inc. ($775).

Total Amount

$4,882

General + Research + Ownership

Payments

205

Total payment records

General Amount

$4,882

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180919002111IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths40273$0
99213Established patient office or other outpatient visit, 20-29 minutes387252$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg18646$0
17000Destruction of precancer skin growth, 1 growth148109$0
17110Destruction of skin growth, 1-14 growths133106$0
View full utilization report →

Insurance plans in this area (ZIP 60045)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537128004View full group profile
NameSpecialtyState
D E R M A T O L O G YIL
D E R M A T O L O G YIL
D E R M A T O L O G YCA
D E R M A T O L O G YIL
D E R M A T O L O G YFL
D E R M A T O L O G YIL
Physician AssistantNC
Physician AssistantIL
D E R M A T O L O G YIA
Physician AssistantNY

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELSEY GRIMMER (PA)?
KELSEY GRIMMER (PA) — NPI 1265695530 — is the standard way to identify this listing.
Does CMS list KELSEY GRIMMER (PA) as active?
Yes — KELSEY GRIMMER (PA) is active in the NPI listing used on this page.
What is KELSEY GRIMMER (PA) best known for clinically?
Directory data describes KELSEY GRIMMER (PA) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect KELSEY GRIMMER (PA) on a map?
Expect Lake Forest, Illinois as a primary anchor for KELSEY GRIMMER (PA) unless the record lists multiple sites.
Why does KELSEY GRIMMER (PA) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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