Individual provider Active NPI

Wladislaw G Fedoriw, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Seminole, FL
National Provider Identifier
1477609899
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME168754 Issued in FL
Practice address
10875 Park Blvd Ste C
Seminole, FL 33772-5456
Phone
(727) 350-0453
Fax
(727) 350-0455
NPI assigned
Jan 26, 2007
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 35835 AZ
Pain Medicine (Anesthesiology) Physician 207LP2900X ME168754 FL
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 35835 AZ
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X ME168754 FL Primary

Addresses

Primary practice location

10875 Park Blvd Ste C
Seminole, FL 33772-5456

Mailing address

501 N Reo St
Tampa, FL 33609-1012
Phone (813) 549-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240609000053 FL Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 5395836738 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Pain Relief Group PLLCGroup PAC ID 4688960271, 80 clinicians

Practice addresses (Care Compare)

10875 Park Blvd
Suite C
Seminole, FL 33772-5456
Phone (727) 350-0453

Merit-based Incentive Payment System (MIPS)

Final score
88.86 of 100Reported as group
Quality
81.56
Improvement activities
40
Cost
78.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management Specialists Pain Medicine CurrentSince May 31, 2024 Accepting new patients
Florida Pain Relief Group PLLC Pain Medicine CurrentSince May 2, 2025 Accepting new patients
Park Center for Procedures LLC CurrentSince May 31, 2024 Accepting new patients
Physician Partners of America Crna Operations LLC PastSince Jun 26, 2017 Accepting new patients

Locations

10301 Hagen Ranch Rd
Ste B270
Boynton Beach, FL 33437
Phone (561) 853-1001

8255 College Pkwy
Fort Myers, FL 33919
Phone (239) 333-7687

8255 College Pkwy
Ste 100
Fort Myers, FL 33919
Phone (239) 267-2900

8255 College Pkwy
Ste 200
Fort Myers, FL 33919
Phone (239) 337-6888

10875 Park Blvd
Ste C
Seminole, FL 33772
Phone (727) 350-0453

3450 E Fletcher Ave
Ste 350
Tampa, FL 33613
Phone (813) 739-7493

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1477609899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N REO ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091012",
            "telephone_number": "813-549-2134",
            "fax_number": "813-864-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 PARK BLVD STE C",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337725456",
            "telephone_number": "727-350-0453",
            "fax_number": "727-350-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORIW",
        "first_name": "WLADISLAW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "35835",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME168754",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "35835",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME168754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.