SHELLY L JOHNSEN (MD) – Family Medicine Physician, NPI 1922016690

Family Medicine Physician

SHELLY L JOHNSEN (MD) is a healthcare provider. based in Manitowoc, Wisconsin. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 45814020 (WI). The NPI Number for SHELLY L JOHNSEN (MD) is 1922016690

Main info

Female

26 Years Of Experience

Accepts Medicare Assignment

Name

SHELLY L JOHNSEN (MD)

NPI

1922016690

Phone

(920) 686-5731

Address

3509 DEWEY ST

Enumeration Date

4 August 2006

Last Update Date

4 September 2018

Doctor Profile

Medical School Name

UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE

Secondary Phone

8778667123

Graduation Year

2000 (26 years ago)

PAC ID

6507956711

Group Practice PAC ID

9830377688

Professional Enrollment ID

I20071212000080

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience52

Completeness75

Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for SHELLY L JOHNSEN (MD)

3509, Dewey Street, Manitowoc, Manitowoc County, Wisconsin, 54220, United States
MANITOWOC, WI 542205813
Phone: (920) 686-5731
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54220)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9830377688View full group profile

Name	Specialty	State
VICTORIA CORAGLIO (M.D.)	Family Practice, Peripheral Vascular Disease	FL
ELLIE MARIE BENTLEY (D.O.)	General Surgery	NJ
DR. NEIL PANDYA (M.D.)	Internal Medicine	IL
SARA GLASSGOW (D.O.)	Family Practice, Peripheral Vascular Disease	FL
DR. LESLIE C MCCLELLAN (MD)	General Surgery	IL
DR. MAGID M FAHIM (M.D.)	Peripheral Vascular Disease, Family Practice	MO
MELISSA M BRAY (M.D.)	Family Practice	IN
JESSIE MAE MONROE (FNP-BC)	Nurse Practitioner	IL
DR. RAYMOND WILLIAM III PRYOR (M.D.)	Family Practice, Peripheral Vascular Disease	FL
MS. NICOLE MARIE PADILLA (M.D.)	Family Practice, Peripheral Vascular Disease	IL