DR. KIMBERLY ANNE WENNER (MD) – Dermatology Physician, NPI 1467442640
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
393 DERMATOLOGY in WA
Provider Addresses for DR. KIMBERLY ANNE WENNER (MD)
101, South Meridian, Puyallup, Pierce County, Washington, 98371, United States
PUYALLUP, WA 983717590
Phone: (253) 848-3000
Fax: (253) 845-8750
Type: Mailing
4907 Point Fosdick Dr NW Ste E700
Gig Harbor, WA 983351842
Phone: (253) 848-3000
Fax: (253) 845-8750
Type: Location
11216 Sunrise Blvd E Ste 3-102
Puyallup, WA 983748848
Phone: (253) 848-3000
Fax: (253) 845-8750
Type: Location
5225 CIRQUE DR W STE 200
UNIVERSITY PLACE, WA 984673639
Phone: (253) 848-3000
Fax: (253) 845-8750
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 33 Open Payments records for all available years, with a total value of $2,998.
Total Amount is formed as General ($2,998) + Research ($0) + Ownership ($0) = $2,998.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Solta Medical, a division of Bausch Health US, LLC ($2,200).
Total Amount
$2,998
General + Research + Ownership
Payments
33
Total payment records
General Amount
$2,998
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Solta Medical, a division of Bausch Health US, LLC | $2,200 |
| ABBVIE INC. | $466 |
| Amgen Inc. | $92 |
| REVANCE THERAPEUTICS, INC. | $61 |
| Galderma Laboratories, L.P. | $32 |
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: 2010-12-13
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 |
|---|---|---|---|---|
| I20101213000657 | I | Dermatology | WA | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 2,083 | 325 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 646 | 519 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 507 | 396 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 304 | 248 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 263 | 217 | $0 |
Insurance plans in this area (ZIP 98371)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | WA | 17003 | Destruction of 2-14 skin growths | 1625 | 266 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | WA | |
| - | WA | |
| O P H T H A L M O L O G Y | WA | |
| D E R M A T O L O G Y | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Physician Assistant | WA | |
| O P H T H A L M O L O G Y | TX | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | WA | |
| O P H T H A L M O L O G Y | WA |
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