Individual provider Active NPI

Nicolas Fedirko, FNP-BC

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1497456206
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704297602 Issued in MI
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

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704297602MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Exclusive Physicians PLLC Family Medicine CurrentSince Apr 1, 2023 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

  • Direct secure messaging: nfedirko867477@direct.hfhs.org
  • Direct secure messaging: 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

Verify at the official NPI Registry.