NATALIE A DOMANGUE-SHIFLETT (MD) – Family Medicine Physician, NPI 1376510123
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
971 FAMILY PRACTICE in ID
Provider Addresses for NATALIE A DOMANGUE-SHIFLETT (MD)
4740 N Penngrove Way
Ste 100
Meridian, ID 83646
Phone: (208) 965-0905
Type: Location
500 W Fort St
Boise, ID 837024501
Phone: (208) 422-1000
Type: Location
North Penngrove Way, Meridian, Ada County, Idaho, 83646, United States
STE 100
MERIDIAN, ID 83646
Phone: (208) 938-3663
Fax: (208) 938-3664
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2023-06-06 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $17 |
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: 2007-10-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20071026000578 | I | Family Practice | 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 83646)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | ID | |
| Family Practice, Osteopathic Manipulative Medicine | ID | |
| Nurse Practitioner | ID | |
| Nurse Practitioner | ID | |
| Nurse Practitioner | ID | |
| - | ID | |
| Nurse Practitioner | ID | |
| Osteopathic Manipulative Medicine, Family Practice | ID | |
| Family Practice | KY | |
| Nurse Practitioner | ID |
Reviews
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