SHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC
NPI 1427410992
Clinic/Center - Adult Mental Health in Green Bay, WI

Q: What is Shelley Boehm Mattia Md,adult Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Active since March 24, 2016

428 DOTY ST, GREEN BAY, WI 54301(920) 965-6768(920) 965-6769 Get Directions Write a Review

NPPES record last updated: October 4, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Shelley Boehm Mattia Md,adult Psychiatry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC (NPI 1427410992) is a healthcare organization registered as an adult mental health in Green Bay, Wisconsin and active in the NPI registry since March 2016. The organization lists Shelley Kathryn Boehm Mattia, Licensed Physician, as its authorized official.

NPPES Registry Identity

NPI1427410992

Entity TypeOrganization

Primary Taxonomy261QM0850X

Legal Business NameSHELLEY BOEHM MATTIA MD,ADULT PSYCHIATRY, LLC

Location Address428 DOTY STGreen Bay, WI 54301-4509

Mailing Address428 Doty StGreen Bay, WI 54301-4509 · (920) 965-6768 · Fax (920) 965-6769

Phone(920) 965-6768

Fax(920) 965-6769

Organization SubpartNo

Authorized OfficialShelley Kathryn Boehm MattiaLicensed Physician · (920) 246-4925

Enumeration DateMarch 24, 2016

Last NPPES UpdateOctober 4, 2016

✔ NPI 1427410992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0850X

License✔ Licensed in WI · 39641

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

428 DOTY ST, Green Bay, WI 54301

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Other Identifiers 2

Medicaid32453500WI

Medicare UPING01884WI

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelley Boehm Mattia Md,adult Psychiatry, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shelley Boehm Mattia MD,adult Psychiatry, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Shelley Boehm Mattia, M.D.

Psychiatry

NPI 1073662938

4845 MORRIS CT
Waunakee, WI 53597

(920) 965-6768

✔ PECOS✔ Accepts Medicare120 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelley Boehm Mattia Md,adult Psychiatry, LLC's NPI number?

The NPI number for Shelley Boehm Mattia Md,adult Psychiatry, LLC is 1427410992. It was assigned to this organization in the NPPES registry on March 24, 2016.

Where is Shelley Boehm Mattia Md,adult Psychiatry, LLC located?

Shelley Boehm Mattia Md,adult Psychiatry, LLC is located at 428 Doty St, Green Bay, WI 54301. The listed phone number is (920) 965-6768.

What is Shelley Boehm Mattia Md,adult Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Is Shelley Boehm Mattia Md,adult Psychiatry, LLC enrolled in Medicare?

Yes. Shelley Boehm Mattia Md,adult Psychiatry, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shelley Boehm Mattia Md,adult Psychiatry, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Shelley Boehm Mattia Md,adult Psychiatry, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shelley Boehm Mattia Md,adult Psychiatry, LLC was last updated on October 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.