Individual provider Active NPI

Diana Carol Fedei, MD

  • Obstetrics & Gynecology Physician
  • Suffolk, VA
National Provider Identifier
1457328080
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0101227826 Issued in VA
Practice address
1005 Commercial LN Ste 230
Suffolk, VA 23434-8149
Phone
(757) 923-4500
Fax
(757) 923-4607
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 0101227826 VA
Obstetrics & Gynecology Physician 207V00000X 0101227826 VA Primary

Addresses

Primary practice location

1005 Commercial LN Ste 230
Suffolk, VA 23434-8149

Mailing address

1005 Commercial LN Ste 230
Suffolk, VA 23434-8149
Phone (757) 923-4500

Other identifiers 9

IdentifierTypeStateIssuer
006216234MedicaidVA
600215472OtherVACIGNA
7896123OtherVAAETNA
1840790OtherVAFIRST HEALTH
28775OtherVAOPTIMA
B8143OtherVAMEDCOST
0701793OtherVAUNITED HEALTH
245441OtherVAANTHEM
390760OtherVAMAMSI

Other names 1

  • Ms. Diana Carol Hicks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20060111000192 VA Practitioner - Obstetrics/Gynecology 6002836558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Eastern Virginia Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1005 Commercial LN
Suite 230
Suffolk, VA 23434-8149
Phone (757) 923-4500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101227826VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genis Womens Care P.C. Gynecology CurrentSince Aug 5, 2002 Accepting new patients

Locations

2790 Godwin Blvd
Ste 375
Suffolk, VA 23434
Phone (757) 923-4500

1005 Commercial Ln
Ste 230
Suffolk, VA 23434
Phone (757) 923-4500

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1457328080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LN STE 230",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-923-4500",
            "fax_number": "757-923-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 COMMERCIAL LN STE 230",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348149",
            "telephone_number": "757-923-4500",
            "fax_number": "757-923-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEI",
        "first_name": "DIANA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VA",
            "license": "0101227826",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101227826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006216234",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "600215472",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7896123",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1840790",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "28775",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B8143",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "0701793",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "245441",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "390760",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "HICKS",
            "middle_name": "CAROL",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.