Catherine A. Fedako, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME57605 Issued in FL

Practice address

2446 Laurel Rd E
North Venice, FL 34275-3204

Phone

(941) 218-6200

Fax

(941) 218-6182

NPI assigned

Sep 8, 2005

Last updated

Mar 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

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.

• Gulf Coast Hma Physician Management LLC

  dba GCMG Laurel Primary Care Clinic

  • Family Medicine Physician
  • North Venice, FL
  • NPI 1518535137
  NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Brooksville, FL
  • NPI 1073131702
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584748800000",
    "number": "1548254204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 LAUREL RD E",
            "city": "NORTH VENICE",
            "state": "FL",
            "postal_code": "342753204",
            "telephone_number": "941-218-6200",
            "fax_number": "941-218-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 LAUREL RD E",
            "city": "NORTH VENICE",
            "state": "FL",
            "postal_code": "342753204",
            "telephone_number": "941-218-6200",
            "fax_number": "941-218-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDAKO",
        "first_name": "CATHERINE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-03-21",
        "certification_date": "2020-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME57605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271354300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anaisis Diaz, APRN
• Renz Marion Malig Dizon
• Stephen E Ducker, MD
• Madelyn Rose Duty, APRN
• Andrea Edwards, DO
• Adriana Paola Fereira Castillo, PHARMD
• Timothy Jason Feliciano Fernandez
• Fitness Quest West Villages, LLC
• Florida Cancer Specialists & Research Institute, LLC
• Alena Gerasimova, M.D.

• Internal Medicine Physician in North Venice, FL
• Providers in North Venice, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2020; 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.