DR. DIMITRI SHCHADENKO (FNP) – Nurse Practitioner, NPI 1104489343
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,538 NURSE PRACTITIONER in CA
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Provider Addresses for DR. DIMITRI SHCHADENKO (FNP)
4788, Crow Canyon Road, Castro Valley, Alameda County, California, 94552, United States
CASTRO VALLEY, CA 945524808
Phone:
Type: Mailing
1000 N Curtis Rd Ste 105
Boise, ID 837061345
Phone: (650) 284-6595
Type: Location
201 JORDAN RD STE 200
FRANKLIN, TN 370674495
Phone: (650) 284-6595
Type: Location
2885 NW 10TH AVE
MERIDIAN, ID 836463159
Phone:
Type: Mailing
2065 E 17TH ST STE A
IDAHO FALLS, ID 834048042
Phone: (800) 640-3451
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-03-02
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220302001792 | I | Nurse Practitioner | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 94552)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | LA | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | TX | |
| Family Practice, Nurse Practitioner | UT |
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