Jessica Marie Mattia-Barry, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1340833 Issued in WI

Practice address

1721 Saemann Ave
Sheboygan, WI 53081-2342

Phone

(920) 783-6633

NPI assigned

Oct 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Lakeshore Community Health Care, IncGroup PAC ID 3173773124, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Sheboygan, WI
  • NPI 1245520519
  Medicare reassignment Care Compare group NPD
• Lakeshore Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • West Bend, WI
  • NPI 1184358004
  NPD
• Lakeshore Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sheboygan, WI
  • NPI 1659959450
  NPD

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1588940951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5361 MEADOWLARK RD",
            "city": "SHEBOYGAN FLS",
            "state": "WI",
            "postal_code": "530852504",
            "telephone_number": "520-419-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 SAEMANN AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530812342",
            "telephone_number": "920-783-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIA-BARRY",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-28",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": "219474-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1340833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Sheboygan",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "N5361 Meadowlark Rd",
            "city": "Sheboygan Fls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530852504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jmattiabarry@lakeshorechc.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "1721 Saemann Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530812342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Matichek
• Caroline Matlock, COTA
• Andrea M Matter, RN
• Matthew Oncology Associates
• H Marshall Matthews, MD
• Jordyn Grace Matuschka, OD
• Cynthia Maxwell, LPC
• David P Mayer, DDS
• Donna Mayer, APNP
• Jenessa Marie Mayer, PA-C

• Family Nurse Practitioner in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.