KELLY MICHELE WILMAS (MD) – Student in an Organized Health Care Education/Training Program, NPI 1972008290
Student in an Organized Health Care Education/Training Program
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
42 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in MO
Provider Addresses for KELLY MICHELE WILMAS (MD)
801 YORK ST
MANITOWOC, WI 542204630
Phone: (920) 663-9008
Fax: (920) 684-1439
Type: Mailing
12855 N 40 DR STE 180
SAINT LOUIS, MO 631418657
Phone: (314) 878-5599
Fax: (314) 392-4290
Type: Location
4020 NEW VISION DR
FORT WAYNE, IN 468451737
Phone: (260) 423-2567
Fax: (260) 420-2415
Type: Location
70 W 94th Pl
Crown Point, IN 463071710
Phone: (219) 662-8822
Fax: (219) 662-8833
Type: Location
8567 Watson Rd Ste A
Webster Groves, MO 631195251
Phone: (314) 528-9040
Fax: (314) 528-9041
Type: Location
130 Richardson Xing Ste 130
Arnold, MO 630106023
Phone: (636) 489-4770
Fax: (636) 489-4880
Type: Location
1223 Maple St
Farmington, MO 636407616
Phone: (573) 760-0091
Fax: (573) 760-8844
Type: Location
6431 FANNIN ST STE MSB 1134
HOUSTON, TX 770301501
Phone: (713) 500-6500
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $786.
Total Amount is formed as General ($786) + Research ($0) + Ownership ($0) = $786.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Organogenesis Inc. ($236).
Total Amount
$786
General + Research + Ownership
Payments
21
Total payment records
General Amount
$786
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
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: 2025-10-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20230515000280 | I | Dermatology | MO | TBD |
| I20251025000108 | I | Dermatology | IN | 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 |
|---|---|---|---|---|
| 17311 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks | 98 | 86 | $0 |
| 17312 | Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks | 87 | 44 | $0 |
| 13132 | Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm | 28 | 28 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 18 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 54220)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | AL | |
| - | WI | |
| Physician Assistant | VA | |
| Physician Assistant | AL | |
| - | 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 |
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