Individual provider Active NPI

Ido Feferkorn, MD

  • Reproductive Endocrinology Physician
  • Tampa, FL
National Provider Identifier
1285405258
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME166279 Issued in FL
Practice address
5245 E Fletcher Ave Ste 1
Tampa, FL 33617
Phone
(813) 914-7304
NPI assigned
Jan 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME166279 FL Primary

Addresses

Primary practice location

5245 E Fletcher Ave Ste 1
Tampa, FL 33617

Mailing address

16310 Ashington Park Dr
Tampa, FL 33647-2639
Phone (813) 334-4944

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 Medicine

State licenses

LicenseStateTypeSpecialty
ME166279FLMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Reproductive Medicine Group Reproductive Endocrinology PastSince Jun 1, 2000 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1285405258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16310 ASHINGTON PARK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472639",
            "telephone_number": "813-334-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 E FLETCHER AVE STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-914-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEFERKORN",
        "first_name": "IDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME166279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.