Dimitri Shchadenko, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

67946 Issued in ID

Practice address

2065 E 17TH St Ste a
Idaho Falls, ID 83404-8042

Phone

(800) 640-3451

NPI assigned

Apr 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dimitri.shchadenko.1@31175.direct.athenahealth.com

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.

• Myfamilydoc

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1346001377
  Medicare reassignment NPD Authorized official
• Spencer J Hardenbrook MD PC

  • Family Medicine Physician
  • Draper, UT
  • NPI 1073909594

  ID

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1104489343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 NW 10TH AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836463159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 E 17TH ST STE A",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048042",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Curtis Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061345",
            "country_code": "US",
            "telephone_number": "650-284-6595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHCHADENKO",
        "first_name": "DIMITRI",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010927",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "67946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amir M Shama, O.D.
• Elizabeth Ann Sharp-Marsden, APRN-CNP
• Michael Meek Sharp, DMD
• Alison Shaw, BS
• Brenda J Shaw, PA
• Sean Richard Shearen, MD
• Derrick Shedd
• Haley Joann Sheffield Evans, DNP, FNP, RN
• Alexis Shelton
• Jolynne Dione Shelton, BS

• Family Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.