Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Nicole Anissa Kujawa, PA

Individual provider Physician Assistant · NPI 1174628341

MS. Nicole Anissa Kujawa, PA is a Physician Assistant in Oconomowoc, Wisconsin. Qualified in 1997, 29 years ago. Practices with Forefront Dermatology SC, a 645-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
29
Licensed in
WI
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1320 Pabst Farms Cir Unit 180
Oconomowoc, WI 53066-4878
Phone: (262) 560-0322
Fax: (262) 560-0379
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16455 W Bluemound Rd, Brookfield, WI 53005-5921 — (262) 784-7820

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1015-23 (WI)

Record details

NPI number1174628341
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 13, 2006
Last updated in NPPESNovember 21, 2025
Certification dateNovember 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Forefront Dermatology Sc — 645 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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