SHANA D FOGARTY (M.D.) – Hospitalist Physician, NPI 1104879899

SHANA D FOGARTY (M.D.) is a healthcare provider. based in Coeur d alene, Idaho. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. MD61238314 (WA). The NPI Number for SHANA D FOGARTY (M.D.) is 1104879899

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
SHANA D FOGARTY (M.D.)
NPI
1104879899
Phone
(208) 625-5085
Address
2003 KOOTENAI HEALTH WAY
Enumeration Date
17 May 2006
Last Update Date
22 December 2021

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
5092217000
Graduation Year
2001 (25 years ago)
PAC ID
3173577269
Group Practice PAC ID
6406805449
Professional Enrollment ID
I20211228000348
Address ID
WA993382722KE3810XWAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience83
Completeness75
Years active:20State licenses:2Digital endpointsOther names

969 FAMILY PRACTICE in ID

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Provider Addresses for SHANA D FOGARTY (M.D.)

  • West Kootenai Health Way, Coeur d'Alene, Kootenai County, Idaho, 83815, United States

    COEUR D ALENE, ID 838146051

    Phone: (208) 625-5085

    Fax: (208) 625-5731

    Mailing address matches the actual address.

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: 2021-12-28

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211228000348IFamily PracticeWATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6845$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and6767$0
99342Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes3434$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2622$0
99238Hospital discharge day management, 30 minutes or less2121$0
View full utilization report →

Insurance plans in this area (ZIP 83814)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406805449View full group profile
NameSpecialtyState
Internal MedicineNC
Family Practice, HospitalistWA
Internal MedicineTX
Internal Medicine, HospitalistWA
Nurse PractitionerTX
Family PracticeNM
Internal MedicineWA
Nurse PractitionerTX
Hospitalist, Internal MedicineWV
Internal MedicineMI

Reviews

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Frequently asked questions

Where can patients find SHANA D FOGARTY (M.D.)'s NPI?
You can confirm SHANA D FOGARTY (M.D.) with NPI 1104879899; it appears in the national provider directory.
Is SHANA D FOGARTY (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SHANA D FOGARTY (M.D.)'s specialty in plain language?
Clinically, the directory lists SHANA D FOGARTY (M.D.) with Hospitalist Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for SHANA D FOGARTY (M.D.)?
The page summarizes Coeur D Alene, Idaho for SHANA D FOGARTY (M.D.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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