Active NPI
Ira Fialko, DO
- Pediatrics Physician
- Crystal River, FL
National Provider Identifier
1174571277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OS4404
- Practice address
- 6171 W Gulf to Lake Hwy
Crystal River, FL 34429-2679 - Phone
- (352) 563-0220
- Fax
- (352) 563-0706
- NPI assigned
- May 4, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OS4404 | FL | Primary |
Addresses
Primary practice location
6171 W Gulf to Lake Hwy
Crystal River, FL 34429-2679
Mailing address
6171 W Gulf to Lake Hwy
Crystal River, FL 34429-2679
Phone (352) 563-0220
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82630 | Other | FL | BCBS OF FLORIDA |
| 202840 | Other | FL | WELLCARE HEALTHEASE |
| 100562 | Other | FL | AVMED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS4404 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ira Fialko DO PA | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Premier Pediatrics Coastal
- Rural Health Clinic/Center
- Crystal River, FL
- NPI 1770865917
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174571277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6171 W GULF TO LAKE HWY",
"city": "CRYSTAL RIVER",
"state": "FL",
"postal_code": "344292679",
"telephone_number": "352-563-0220",
"fax_number": "352-563-0706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6171 W GULF TO LAKE HWY",
"city": "CRYSTAL RIVER",
"state": "FL",
"postal_code": "344292679",
"telephone_number": "352-563-0220",
"fax_number": "352-563-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIALKO",
"first_name": "IRA",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "OS4404",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FLORIDA",
"identifier": "82630",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE HEALTHEASE",
"identifier": "202840",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "100562",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crystal River, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.