Adam Ross Fedyk, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2008009796 Issued in MO

Practice address

1585 Woodlake Dr.
Suite 106
Town & Country, MO 63017

Phone

(314) 326-4800

Fax

(314) 266-0558

NPI assigned

Jun 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Ophthalmology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: afedyk@slei.intellechartdirect.net

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.

• St. Louis Eye Institute, PC

  • Ophthalmology Physician
  • Chesterfield, MO
  • NPI 1396161840
  Medicare reassignment Authorized official
• Ophthalmology Consultants, LLC

  • Ophthalmology Physician
  • Saint Louis, MO
  • NPI 1003960980
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1356544209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR.",
            "address_2": "SUITE 106",
            "city": "TOWN & COUNTRY",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-326-4800",
            "fax_number": "314-266-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR.",
            "address_2": "SUITE 106",
            "city": "TOWN & COUNTRY",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-326-4800",
            "fax_number": "314-266-0558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Saint Peters Centre Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761695",
            "country_code": "US",
            "telephone_number": "314-326-4800",
            "fax_number": "314-266-0558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDYK",
        "first_name": "ADAM",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2008009796",
            "primary": true
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "MO",
            "license": "2008009796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afedyk@slei.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "1585 Woodlake Dr.",
            "address_2": "Suite 106",
            "city": "Town & Country",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allied Physicians Group LLC
• Christine M. Dohr, LLC
• Delmar Gardens West Operating, LLC
• Dana Noelle Demartini, LMT
• Nancy Grosze
• Mary A Hackworth
• Michele G Hahn
• Jean S Hantak
• Niccole Havrilka

• Ophthalmology Physician in Town & Country, MO
• Providers in Town & Country, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.