NICHOLAS PATRICK GRIMM (PA-C) – Physician Assistant, NPI 1104023381
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for NICHOLAS PATRICK GRIMM (PA-C)
3515 MURRAY ST
MARINETTE, WI 541433367
Phone: (715) 732-0699
Fax: (715) 732-3522
Type: Location
715 Superior Rd Ste 120
Green Bay, WI 543117595
Phone: (920) 406-9803
Fax: (920) 406-9934
Type: Location
N4531 State Highway 22 Ste 5
Shawano, WI 541666173
Phone: (715) 524-5995
Fax: (715) 953-4257
Type: Location
Green Bay, Broadway, Queens, New York, 11373, United States
GREEN BAY, WI 543032728
Phone: (920) 288-8240
Fax: (920) 288-8255
Type: Mailing
2605, Development Drive, Bellevue, Brown County, Wisconsin, 54311, United States
GREEN BAY, WI 543114240
Phone: (920) 288-8240
Fax: (920) 288-8255
Type: Location
801 YORK ST
MANITOWOC, WI 542204630
Phone: (920) 663-9008
Fax: (920) 684-1439
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 280 Open Payments records for all available years, with a total value of $4,554.
Total Amount is formed as General ($4,554) + Research ($0) + Ownership ($0) = $4,554.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($664).
Total Amount
$4,554
General + Research + Ownership
Payments
280
Total payment records
General Amount
$4,554
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Regeneron Healthcare Solutions, Inc. | $664 |
| ABBVIE INC. | $536 |
| Janssen Biotech, Inc. | $460 |
| GENZYME CORPORATION | $407 |
| Arcutis Biotherapeutics, Inc. | $244 |
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: 2007-07-27
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 |
|---|---|---|---|---|
| I20070727000315 | I | Physician Assistant | WI | 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 | 1,140 | 253 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,082 | 816 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 537 | 407 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 407 | 359 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 208 | 31 | $0 |
Insurance plans in this area (ZIP 54143)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Physician Assistant | VA | |
| - | VA | |
| D E R M A T O L O G Y | TX | |
| - | WI | |
| D E R M A T O L O G Y | AL | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| Physician Assistant | NY | |
| D E R M A T O L O G Y | WA |
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