Ladislav Fedorko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-071881 Issued in OH

Practice address

1350 W Bagley Rd
Berea, OH 44017-2912

Phone

(440) 816-5188

NPI assigned

Mar 31, 2006

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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mobile Hyperbaric Centers, LLCGroup PAC ID 4082682778, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lfedorko@direct.swgeneral.com

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.

• Mobile Hyperbaric Centers, LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Cleveland, OH
  • NPI 1568410686
  Medicare reassignment Care Compare group NPD

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

• Southwest General Health Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1154353993
  Care Compare affiliation

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1245291913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172912",
            "telephone_number": "440-816-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORKO",
        "first_name": "LADISLAV",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-071881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000142087",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5049663",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "83648",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076033",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341908694027",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUMMACARE",
            "identifier": "F71881",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0104797",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent Evanoff, PA-C
• Jacklyn Ann Fairchild, P.C., N.C.C
• Mackenzie Paige Faluski
• Annmarie Fani
• Spencer Farrar, DPT
• Melanie Fenske, RN
• Diane Ferry
• Caitlin Filips, O.D.
• Catherine Filkill
• Hanna Fortney

• Family Medicine Physician in Berea, OH
• Providers in Berea, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.