Shanna Rachelle Vidor, MD is a medicare enrolled "Family Medicine" physician in Nett Lake, Minnesota. She went to University Of North Dakota School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Bois Forte Reservation Tribal Council and her current practice location is
5219 St John Drive, Nett Lake, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 757-3295.
Shanna Rachelle Vidor is licensed to practice in Minnesota (license number 55689) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1215229729.
Physician's Profile
Full Name | Shanna Rachelle Vidor |
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Gender | Female |
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Speciality | Family Practice |
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Experience | 13 Years |
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Location | 5219 St John Drive, Nett Lake, Minnesota |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Shanna Rachelle Vidor attended and graduated from University Of North Dakota School Of Medicine in 2011
NPI Data:
- NPI Number: 1215229729
- Provider Enumeration Date: 05/03/2011
- Last Update Date: 06/18/2020
Medicare PECOS Information:
- PECOS PAC ID: 9830349380
- Enrollment ID: I20121018000799
Medical Identifiers
Medical identifiers for Shanna Rachelle Vidor such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215229729 | NPI | - | NPPES |
1215229729 | Medicaid | MN | |
P01105126 | Other | MN | RAILROAD MEDICARE |
1215229729 | Other | | MEDICA |
1215229729 | Other | MN | BCBS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 55689 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Bois Forte Reservation Tribal Council | 7517879778 | 6 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shanna Rachelle Vidor allows following entities to bill medicare on her behalf.
Entity Name | Bois Forte Reservation Tribal Council |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073530150 PECOS PAC ID: 7517879778 Enrollment ID: O20031105000284 |
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Entity Name | Duluth Graduate Medical Education Council Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1972585867 PECOS PAC ID: 4385545953 Enrollment ID: O20040116000311 |
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Entity Name | Cook Area Health Services, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174596027 PECOS PAC ID: 4880681303 Enrollment ID: O20040427001470 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shanna Rachelle Vidor is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shanna Rachelle Vidor, MD 5219 St John Drive, Nett Lake, MN 55772-8232 Ph: (218) 757-3295 | Shanna Rachelle Vidor, MD 5219 St John Drive, Nett Lake, MN 55772-8232 Ph: (218) 757-3295 |
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