Dr Shane C Fogo, MD - Medicare Family Medicine in Eureka, IL

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Dr Shane C Fogo, MD is a medicare enrolled "Family Medicine" physician in Eureka, Illinois. His current practice location is 105 S Major St, Eureka, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 467-4691.

Dr Shane C Fogo is licensed to practice in Illinois (license number 036111674) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063446318.

Contact Information

Dr Shane C Fogo, MD
105 S Major St,
Eureka, IL 61530-1246
(309) 467-4691
Not Available

Map and Direction




Physician's Profile

Full NameDr Shane C Fogo
GenderMale
SpecialityFamily Medicine
Location105 S Major St, Eureka, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063446318
  • Provider Enumeration Date: 07/11/2006
  • Last Update Date: 12/14/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 2365408606
  • Enrollment ID: I20041208000245

Medical Identifiers

Medical identifiers for Dr Shane C Fogo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063446318NPI-NPPES
036111674MedicaidIL
10215111OtherILBCBS TCH
5715395OtherILBCBS HPT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 036111674 (Illinois)Primary

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. Dr Shane C Fogo allows following entities to bill medicare on his behalf.
Entity NameAdvocate Health And Hospitals Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700824455
PECOS PAC ID: 7810800935
Enrollment ID: O20031106000064
Entity NameCarle West Physician Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467074138
PECOS PAC ID: 8921420308
Enrollment ID: O20200613000147
Entity NameCarle Bromenn Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104442615
PECOS PAC ID: 8921429499
Enrollment ID: O20200716000187

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. Dr Shane C Fogo 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 AddressPractice Location Address
Dr Shane C Fogo, MD
701 Lee St, Suite 300,
Des Plaines, IL 60016-4539

Ph: (847) 390-5900		Dr Shane C Fogo, MD
105 S Major St,
Eureka, IL 61530-1246

Ph: (309) 467-4691

Reviews and Comments


Family Medicine Doctors in Eureka, IL

Dr. Christopher R. Hughes, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 105 S Major St, Eureka, IL 61530
Phone: 309-467-4691    Fax: 309-467-6229
Nicholas Weber, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 105 S Major St, Eureka, IL 61530
Phone: 309-467-4691    
Dr. David L. Miller, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 105 S Major St, Eureka, IL 61530
Phone: 309-467-4691    Fax: 309-467-6229
Dr. Steven K. Jones, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 105 S Major St, Eureka, IL 61530
Phone: 309-467-4691    Fax: 309-467-6229
Dr. Keith E. Knepp, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 105 S Major St, Eureka, IL 61530
Phone: 309-467-4691    Fax: 309-467-6229

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.