DR. DIMITRI SHCHADENKO FNP
NPI 1104489343
Nurse Practitioner - Family in Idaho Falls, ID

Q: What is Dimitri Shchadenko's NPI number?

The NPI number for Dimitri Shchadenko is 1104489343. It was assigned to this individual provider in the NPPES registry on April 14, 2019.

Q: What is Dimitri Shchadenko's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since April 14, 2019PECOS EnrolledAccepts Medicare Assignment

2065 E 17TH ST STE A, IDAHO FALLS, ID 83404(800) 640-3451 Get Directions Write a Review

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 20, 2026, Feb 15, 2022, Apr 14, 2019 (3 updates tracked since 2019).

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About Dr. Dimitri Shchadenko Fnp NPPES

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

DR. DIMITRI SHCHADENKO FNP (NPI 1104489343) is an individual family provider in Idaho Falls, Idaho, licensed in Idaho (67946) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Boise, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1104489343

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameDR. DIMITRI SHCHADENKOCredential: FNP

Location Address2065 E 17TH ST STE AIdaho Falls, ID 83404-8042

Mailing Address2885 Nw 10th AveMeridian, ID 83646-3159

Phone(800) 640-3451

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateApril 14, 2019

Last NPPES UpdateMarch 20, 20263 updates tracked since enumeration

NPPES CertifiedMarch 20, 2026

✔ NPI 1104489343 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in ID · 67946✔ Licensed in CA · 95010927

2065 E 17TH ST STE A, Idaho Falls, ID 83404

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Secondary Practice Location 1

Location 11000 N Curtis Rd Ste 105Boise, ID 83706-1345 · Phone (650) 284-6595

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dimitri Shchadenko Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315273125

PECOS Enrollment IDI20220302001792

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83404 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

Other Providers at the Same Location NPPES 6

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

RYAN MCBRIDE

Nurse Practitioner (Family)