KRISTOFER MICHAEL WALLMAN (MPAS, PA-C) – Medical Physician Assistant, NPI 1962439547
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
Provider Addresses for KRISTOFER MICHAEL WALLMAN (MPAS, PA-C)
94105 PAULUS RD
STURGEON LAKE, MN 557833812
Phone: (218) 485-5793
Type: Mailing
22957 27TH AVE
SAINT AUGUSTA, MN 563012201
Phone: (218) 341-3031
Type: Mailing
700 PENN ST
FOLEY, MN 563298700
Phone: (320) 774-3636
Fax: (320) 774-3360
Type: Location
TWIN PORTS VA OUTPATIENT CLINIC
3520 TOWER AVE.
SUPERIOR, WI 548805335
Phone: (715) 398-2931
Fax: (715) 398-2923
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $128.
Total Amount is formed as General ($128) + Research ($0) + Ownership ($0) = $128.
Last reported payment date: 2024-11-21 • Largest payer in this snapshot: Biofrontera Inc. ($33).
Total Amount
$128
General + Research + Ownership
Payments
7
Total payment records
General Amount
$128
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-21
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-07-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040706000403 | I | Physician Assistant | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J7345 | Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg | 6,200 | 21 | $0 |
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,296 | 186 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 255 | 208 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 245 | 179 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 215 | 174 | $0 |
Insurance plans in this area (ZIP 55783)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Physician Assistant | MN | |
| D E R M A T O L O G Y | MN | |
| Family Practice, Dermatology | MI |
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