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Active NPI 1154722155 Individual Practitioner Female Practitioner

Shelby Lidstrom

Physician Assistant • Monroe, WA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Shelby Lidstrom is a certified Physician Assistant practicing in Monroe, WA. With approximately 19 years of clinical experience since completing medical education in 2007, Shelby Lidstrom delivers high-quality medical care to the local community at 19200 N KELSEY ST.

Shelby Lidstrom is affiliated with Kootenai Health Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

19200 N Kelsey St

Monroe, WA 982721431

Telephone 3607947994
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Monroe, WA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
19 Yrs +5.9 yrs vs City Avg
City Avg: 13.1 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
10 Specialists

Practicing in Monroe, WA (3774 Statewide)

Telehealth Adoption Rate
40.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
59.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lidstrom (19 Years) 19 Yrs
Monroe Specialty Average (13.1 Years) 13.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
102 63 $173.00 $76.07
99213 Established patient office or other outpatient visit, typically 15 minutes
80 58 $112.00 $51.61
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
49 42 $27.00 $12.98
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
25 25 $232.00 $101.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
19 19 $180.00 $64.17
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
17 17 $291.00 $104.23

Medical Specialties & State Licenses

CMS Verified: 2025-07-24
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WA PA60463924

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License ID PA-2541

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Kootenai Health Inc

1919 Lincoln Way, Coeur D Alene, ID 838142527

Kootenai Health Inc

1055 Riverside Ave, Orofino, ID 835449029

Phone: 2084765777

Secondary Practice Locations

1919 Lincoln Way Ste 315

Coeur D Alene, ID 838142527

Phone: 2086256000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

32 Associated Practitioners
A Pell , PA-C

Physician Assistant

NPI 1013968254

Physician Assistant (Certified)

Dr. Rhonda Bass , MD

Family Medicine

NPI 1023014925

Doctor of Medicine (M.D.)

NPI 1023704244

Doctor of Medicine (M.D.)

NPI 1073614376

Doctor of Medicine (M.D.)

Poonam Patel

Pharmacist

NPI 1174053540
Dr. Thomas Garges , MD

Family Medicine

NPI 1255314290

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2025

Physician Assistant (License #PA-2541 in ID)

NPI Profile Active September 09, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location September 09, 2014

Registered at 19200 N KELSEY ST, MONROE, WA 982721431 (Tel: 3607947994)

📍
Updated Business Mailing Address September 09, 2014

Registered at PO BOX 3360, PORTLAND, OR 972083360 (Tel: 8663662983)

👤
Provider Name / Credentials Updated September 09, 2014

Recorded as SHELBY LIDSTROM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 09, 2014

Physician Assistant (License #PA60463924 in WA)

🟢
Initial NPI Registration & Enumeration September 09, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154722155
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 09, 2014
Last Update: July 24, 2025
Sole Proprietor: No

Mailing Address

Po Box 3360

Portland, OR 972083360

Phone: 8663662983

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.