Robert Myron Fedorow, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704280907 Issued in MI

Practice address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Phone

(586) 524-0854

NPI assigned

Sep 22, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, HI2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Wayne State University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Genesys HospitalGroup PAC ID 2062323033, 85 clinicians

Pacific Anesthesia IncGroup PAC ID 1951596329, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rfedorow1126636@direct.hfhs.org
• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Ford Health Genesys Hospital

  dba Henry Ford Genesys Hospital

  • Certified Registered Nurse Anesthetist
  • Grand Blanc, MI
  • NPI 1558517367

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Pacific Anesthesia, Inc

  • Anesthesiology Physician
  • Honolulu, HI
  • NPI 1538472451
  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Michigan PLLC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1871986372

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ascension Genesys Hospital

  dba Ascension Genesys Short Term Rehabilitation Center

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1093125312
  NPD
• American Anesthesiology Associates of Michigan, PC

  • Anesthesiology Physician
  • Grand Blanc, MI
  • NPI 1235181223

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1033668850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 STREAMWOOD CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093389",
            "telephone_number": "586-524-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "586-524-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOROW",
        "first_name": "ROBERT",
        "middle_name": "MYRON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704280907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sami Faltas, PT
• Family Care Chiropractic
• Zouheir Fares, D.O.
• Stephanie Ann Farrand, LPC
• Tonya Dawn Farrer, MA, LLP, CAAC
• Connie Ferguson, OTR
• Jocelyn Kay Ferguson
• Dawn Ferran, MSW
• Shawn Fickies
• Andrea Fields

• Certified Registered Nurse Anesthetist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.