Carl John Fedyszyn, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

7326 Issued in ND

Practice address

166 19TH St S
Suite #201
Sartell, MN 56377-4654

Phone

(320) 259-1405

Fax

(320) 259-5896

NPI assigned

Feb 4, 2009

Last updated

Dec 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Minnesota Neurosciences LTD

  • Neurological Surgery Physician
  • Saint Cloud, MN
  • NPI 1972520773
  NPD (past)

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1528207156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 19TH ST S",
            "address_2": "SUITE #201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774654",
            "telephone_number": "320-259-1405",
            "fax_number": "320-259-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 19TH ST S",
            "address_2": "SUITE #201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774654",
            "telephone_number": "320-259-1405",
            "fax_number": "320-259-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDYSZYN",
        "first_name": "CARL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "7326",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "37093",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00048363",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-9986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idil Saysal Farah
• Sirat Abdullahi Farah
• Kaila M Farnsworth
• Allison Page Fassler, BS, LADC
• Makayla Amber Feddersen
• Karena Faye Finch
• Bonnie P Fines, M.D.
• Ivy A Fingalson
• Christine Fischer
• Kristal Nicole Flec

• Family Medicine Physician in Sartell, MN
• Providers in Sartell, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.