SHAD FLY
NPI 1861055006
Nurse Anesthetist, Certified Registered in Spokane, WA
About Shad Fly NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAD FLY (NPI 1861055006) is an individual nurse anesthetist, certified registered in Spokane, Washington, licensed in Washington (AP61299457) and active in the NPI registry since April 2019. He is affiliated with Deaconess Medical Center and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shad Fly 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.
Medicare Billing Reassignment
Medicare enrollment records show Shad Fly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Spokane, WA 99204
- Reassigned Medicare billing, Washington enrollment
- 102 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Deaconess Medical Center
Acute Care Hospitals · Spokane, WAMulticare Valley Hospital
Acute Care Hospitals · Spokane, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 99204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SPOKANE, WA 99204
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 Shad Fly's NPI number?
The NPI number for Shad Fly is 1861055006. It was assigned to this individual provider in the NPPES registry on April 15, 2019.
Where is Shad Fly located?
Shad Fly practices at 800 W 5th Ave, Spokane, WA 99204. The listed phone number is (509) 458-5800.
What is Shad Fly's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Shad Fly enrolled in Medicare?
Yes. Shad Fly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Shad Fly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shad Fly reassigns Medicare benefits to Anesthesia Associates, Ps (Spokane, WA). The 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 Shad Fly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Shad Fly affiliated with any hospitals?
According to CMS data, Shad Fly is affiliated with Deaconess Medical Center and Multicare Valley Hospital.
When was this NPI record last updated?
The NPPES record for Shad Fly was last updated on June 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Shad Fly · NPI 1861055006
Nurse Anesthetist, Certified Registered physician in Spokane, Washington. Individual provider, active in the CMS NPPES registry since April 15, 2019.
## Identity
- **NPI:** 1861055006 (Entity type: Individual)
- **Enumerated:** April 15, 2019
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** AP61299457 (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 800 W 5TH AVE, Spokane, WA 99204-2803
- **Phone:** (509) 458-5800
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Anesthesia Associates, Ps (NPI 1831143254, Spokane, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** June 22, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1861055006) · Data from the CMS NPPES public registry.