Individual provider Active NPI

Shelly Wenzel Reimer, M.D.

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1306200886
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
68174 Issued in WI
Practice address
1789 Shawano Ave
Green Bay, WI 54303-3243
Phone
(920) 499-1428
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 68174 WI Primary

Addresses

Primary practice location

1789 Shawano Ave
Green Bay, WI 54303-3243

Mailing address

1789 Shawano Ave
Green Bay, WI 54303-3243
Phone (920) 499-1428

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-3750

Other identifiers 1

IdentifierTypeStateIssuer
1306200886MedicaidWI

Other names 1

  • Michelle Kristen Wenzel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210519002056 WI Practitioner - Diagnostic Radiology 2769881044 Reassigns benefits to 3 organizations
I20240320004044 MI Practitioner - Diagnostic Radiology 2769881044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology CharteredGroup PAC ID 1557394988, 39 clinicians

Practice addresses (Care Compare)

Marquette, MI 49855
Phone (920) 499-2766

1789 Shawano Ave
Green Bay, WI 54303-3243
Phone (920) 499-1428

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113
  • Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68174WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Chartered Diagnostic Radiology CurrentSince Jan 4, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 13, 2021 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Mar 13, 2021 Accepting new patients

Locations

1905 N Calhoun Rd
Brookfield, WI 53005
Phone (262) 333-0040

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1789 Shawano Ave
Green Bay, WI 54303

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1306200886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033243",
            "telephone_number": "920-499-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033243",
            "telephone_number": "920-499-1428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-3750",
            "fax_number": "414-259-9290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIMER",
        "first_name": "SHELLY",
        "middle_name": "WENZEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "68174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306200886",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "WENZEL",
            "middle_name": "KRISTEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.