Active NPI
Nicolas Fedirko, FNP-BC
- Family Nurse Practitioner
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704297602
- Practice address
- 26300 Woodward Ave
Royal Oak, MI 48067-0917 - Phone
- (248) 336-4000
- Fax
- (248) 336-9137
- NPI assigned
- Mar 17, 2023
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704297602 | MI | Primary |
Addresses
Primary practice location
26300 Woodward Ave
Royal Oak, MI 48067-0917
Mailing address
18000 W 9 Mile Rd Ste 200
Southfield, MI 48075-4020
Phone (248) 336-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704297602 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exclusive Physicians PLLC | Family Medicine | Current | Accepting new patients |
Locations
3051 Momentum Pl
Chicago, IL 60689
20901 W 7 Mile Rd
Detroit, MI 48219
Phone (313) 532-2000
4059 W Davison
Detroit, MI 48238
Phone (313) 491-5400
911 E 9 Mile Rd
Ferndale, MI 48220
Phone (248) 543-2229
3499 S Linden Rd
Ste 2
Flint, MI 48507
Phone (810) 820-8121
26300 Woodward Ave
Royal Oak, MI 48067
Phone (248) 546-2110
29829 Telegraph Rd
Ste 202
Southfield, MI 48034
Phone (248) 208-9411
18000 W 9 Mile Rd
Ste 200
Southfield, MI 48075
29829 Telegraph Rd
Ste 200
Southfield, MI 48034
Phone (248) 353-3500
Interoperability endpoints
- nfedirko867477@direct.hfhs.org
- nicolas.fedirko.1@33060.direct.athenahealth.com
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": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765843200000",
"number": "1497456206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18000 W 9 MILE RD STE 200",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754020",
"telephone_number": "248-336-4000",
"fax_number": "248-336-9137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26300 WOODWARD AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480670917",
"telephone_number": "248-336-4000",
"fax_number": "248-336-9137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDIRKO",
"first_name": "NICOLAS",
"name_prefix": "Dr.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-17",
"last_updated": "2025-12-16",
"certification_date": "2025-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704297602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.