SHELBY LIDSTROM
NPI 1154722155
Physician Assistant in Monroe, WA

Q: What is Shelby Lidstrom's NPI number?

The NPI number for Shelby Lidstrom is 1154722155. It was assigned to this individual provider in the NPPES registry on September 9, 2014. The provider is also known as Shelby A Myers Pa-C.

Q: What is Shelby Lidstrom's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Shelby Lidstrom was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.

Active since September 09, 2014PECOS EnrolledAccepts Medicare Assignment

94.91/100

CMS Quality Rating

19200 N KELSEY ST, MONROE, WA 98272(360) 794-7994 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Shelby Lidstrom NPPES

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

SHELBY LIDSTROM (NPI 1154722155) is an individual physician assistant in Monroe, Washington, licensed in Washington (PA60463924) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and maintains a secondary practice location in Coeur D Alene.

NPPES Registry Identity

NPI1154722155

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSHELBY LIDSTROM

Location Address19200 N KELSEY STMonroe, WA 98272-1431

Mailing AddressPo Box 3360Portland, OR 97208-3360 · (866) 366-2983

Phone(360) 794-7994

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateSeptember 9, 2014

Last NPPES UpdateJuly 24, 2025

NPPES CertifiedJuly 24, 2025

✔ NPI 1154722155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in WA · PA60463924✔ Licensed in ID · PA-2541

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

19200 N KELSEY ST, Monroe, WA 98272

Open in Google Maps ↗

Other Names 1

Former Name (1)Shelby A Myers Pa-c

Secondary Practice Location 1

Location 11919 Lincoln Way Ste 315Coeur D Alene, ID 83814-2527 · Phone (208) 625-6000 · Fax (208) 625-6001

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and more.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

Shelby Lidstrom 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 ID6204056807

PECOS Enrollment IDI20230906000879

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

102 services63 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

80 services58 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

25 services25 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

19 services19 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

17 services17 patients

Hospital Affiliations CMS Care Compare

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98272 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.91/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.83

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

A CHANCELLOR PELL PA-C

Physician Assistant