Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Dimitri Shchadenko, FNP

Individual provider Family Nurse Practitioner · NPI 1104489343

Dr. Dimitri Shchadenko, FNP is a Nurse Practitioner in Idaho Falls, Idaho. Qualified in 2018, 8 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
8
Licensed in
CA, ID
In the registry since
2019
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

2065 E 17th St Ste A
Idaho Falls, ID 83404-8042
Phone: (800) 640-3451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 N Curtis Rd Ste 105, Boise, ID 83706-1345 — (650) 284-6595

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 67946 (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 95010927 (CA)

Record details

NPI number1104489343
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorYes
NPI enumeratedApril 14, 2019
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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