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DR. SHANE C. FOGO M.D.
NPI 1063446318
Family Medicine in Eureka, IL

Active since July 11, 2006PECOS Enrolled
105 S MAJOR ST, EUREKA, IL 61530(309) 467-4691 Get Directions Write a Review

NPPES record last updated: December 14, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Shane C. Fogo M.d. NPPES

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

DR. SHANE C. FOGO M.D. (NPI 1063446318) is an individual family medicine provider in Eureka, Illinois, licensed in Illinois (036111674) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2002).

NPPES Registry Identity

NPI1063446318
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANE C. FOGOCredential: M.D.
Location Address105 S MAJOR STEureka, IL 61530-1246
Mailing Address701 Lee St, Suite 300Des Plaines, IL 60016-4539 · (847) 390-5900
Phone(309) 467-4691
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2002
Enumeration DateJuly 11, 2006
Last NPPES UpdateDecember 14, 2012
✔ NPI 1063446318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036111674
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
105 S MAJOR ST, Eureka, IL 61530
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Other Identifiers 7

Other10215111IL · Bcbs Tch
Other5715395IL · Bcbs Hpt
Medicare ID-Type Unspecified712180IL · Medicare Group Tch
Medicare ID-Type Unspecified748940IL · Medicare Group Hpt
Medicare ID-Type UnspecifiedK28868IL · Medicare Pin Tch
Medicaid036111674IL
Medicare ID-Type UnspecifiedK13837IL · Medicare Pin Hpt

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shane C. Fogo M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365408606
PECOS Enrollment IDI20041208000245
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Shane Fogo reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carle Eureka Hospital
Same address
Critical Access
101 S MAJOR ST
Eureka, IL 61530
  • Reassigned Medicare billing, Illinois enrollment
  • 97 clinicians in this Medicare group
NPI 1184644023 (309) 467-2371
Advocate Health And Hospitals Corp.
Same address
Medicare Defined Swing Bed Unit
101 S MAJOR ST
Eureka, IL 61530
  • Reassigned Medicare billing, Illinois enrollment
  • 4,870 clinicians in this Medicare group
NPI 1295066983 (309) 467-2371
Carle West Physician Group Inc
21 mi
Family Medicine
1302 FRANKLIN AVE STE 3400
Normal, IL 61761
  • Reassigned Medicare billing, Illinois enrollment
  • 698 clinicians in this Medicare group
NPI 1467074138 (309) 556-8295
Carle Bromenn Medical Center
21 mi
Clinic/Center
1300 FRANKLIN AVE STE 100
Normal, IL 61761
  • Reassigned Medicare billing, Illinois enrollment
  • 71 clinicians in this Medicare group
NPI 1104442615 (309) 454-1400
Carle Health Medical Group
70 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300

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

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Proctor Hospital

Acute Care Hospitals · Peoria, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140013
Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County
Emergency services

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Carle Bromenn Medical Center

Acute Care Hospitals · Normal, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140127
Location1304 Franklin AvenueNormal, IL 61761 · Mc Lean County
Emergency services Birthing friendly

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Carle Eureka Hospital

Critical Access Hospitals · Eureka, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141309
Location101 S Major StEureka, IL 61530 · Woodford County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61530 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 20

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers60 claims154 services$5.93 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers31 claims40 services$1.05 avg. paid by Medicare
Male external catheter, with or without adhesive, disposable, each A4349
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims330 services$1.94 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier11 claims22 services$9.38 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
10 suppliers55 claims55 services$36.87 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
9 suppliers33 claims33 services$86.11 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MORGAN ELIZABETH HARRIS CNP
Nurse Practitioner (Family)
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
DR. CHRISTOPHER R. HUGHES M.D.
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
NICHOLAS WEBER DO
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
DR. DAVID L. MILLER M.D.
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
BROMENN PHYSICIANS MANAGEMENT CORPORATION
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
CARLE EUREKA HOSPITAL
Clinic/Center (Rural Health)
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
ALEXA MILLER
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691
DR. STEVEN K. JONES MD
Family Medicine
105 S MAJOR ST
EUREKA, IL 61530
Woodford County (309) 467-4691

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 Shane Fogo's NPI number?

The NPI number for Shane Fogo is 1063446318. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Shane Fogo located?

Shane Fogo practices at 105 S Major St, Eureka, IL 61530. The listed phone number is (309) 467-4691.

What is Shane Fogo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shane Fogo enrolled in Medicare?

Yes. Shane Fogo is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shane Fogo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Fogo reassigns Medicare benefits to 5 organizations: Carle Eureka Hospital (Eureka, IL), Advocate Health And Hospitals Corp. (Eureka, IL), Carle West Physician Group Inc (Normal, IL), Carle Bromenn Medical Center (Normal, IL) and Carle Health Medical Group (Urbana, IL). Each 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 Shane Fogo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Shane Fogo affiliated with any hospitals?

According to CMS data, Shane Fogo is affiliated with Proctor Hospital, Saint Francis Medical Center, Carle Bromenn Medical Center, Methodist Medical Center Of Illinois and Carle Eureka Hospital.

When was this NPI record last updated?

The NPPES record for Shane Fogo was last updated on December 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.