Active NPI
Erik W Fedor, PHYSICIAN ASSISTANT
- Medical Physician Assistant
- Wheat Ridge, CO
National Provider Identifier
1285886887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 3550 Lutheran Parkway
Suite 200
Wheat Ridge, CO 80033 - Phone
- (303) 425-9900
- Fax
- (303) 425-0883
- NPI assigned
- Oct 15, 2008
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
3550 Lutheran Parkway
Suite 200
Wheat Ridge, CO 80033
Mailing address
3550 Lutheran Parkway
Suite 200
Wheat Ridge, CO 80033
Phone (303) 425-9900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1532 | Other | CO | PA LICENSE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1285886887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 LUTHERAN PARKWAY",
"address_2": "SUITE 200",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "80033",
"telephone_number": "303-425-9900",
"fax_number": "303-425-0883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 LUTHERAN PARKWAY",
"address_2": "SUITE 200",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "80033",
"telephone_number": "303-425-9900",
"fax_number": "303-425-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDOR",
"first_name": "ERIK",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-15",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA LICENSE",
"identifier": "1532",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.