Active NPI
Eleonora Fedonenko, M.D.
- Internal Medicine Physician
- Los Angeles, CA
National Provider Identifier
1790721850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A65259
- Practice address
- 6221 Wilshire Blvd
Suite 312
Los Angeles, CA 90048-5201 - Phone
- (323) 655-0990
- NPI assigned
- Jun 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A65259 | CA | Primary |
Addresses
Primary practice location
6221 Wilshire Blvd
Suite 312
Los Angeles, CA 90048-5201
Mailing address
6221 Wilshire Blvd
Suite 312
Los Angeles, CA 90048-5201
Phone (323) 655-0990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A652590 | Medicaid | CA | |
| 1790721850 | Other | CA | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031229000953 | CA | Practitioner - Internal Medicine | 2567360571 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Eleonora Fedonenko MD and David Vizel MD a Professional Medical Co
Practice addresses (Care Compare)
6221 Wilshire Blvd
Suite 312
Los Angeles, CA 90048-5225
Phone (323) 655-0990
Hospital & facility affiliations
- Ahg Home Health, Inc.
- Helping Hands Home Health Best Care, Inc
- Santa Home Health Care, Inc.
- Supportive Home Health Care Corp
- Reliable Home Healthcare Services
- Cedars-Sinai Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eleonora Fedonenko MD and David Vizel MD a Professional Medical Co | Internal Medicine | Current | Accepting new patients |
Locations
6221 Wilshire Blvd
Ste 312
Los Angeles, CA 90048
Phone (323) 655-0990
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1649212028
CA, Internal Medicine
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Agoura Hills, CA
- NPI 1932726973
-
- Home Health Agency
- Glendale, CA
- NPI 1558964155
-
- Home Health Agency
- Van Nuys, CA
- NPI 1558977215
-
- Home Health Agency
- Los Angeles, CA
- NPI 1730322884
-
- Home Health Agency
- Encino, CA
- NPI 1528278959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1790721850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 WILSHIRE BLVD",
"address_2": "SUITE 312",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900485201",
"telephone_number": "323-655-0990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6221 WILSHIRE BLVD",
"address_2": "SUITE 312",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900485201",
"telephone_number": "323-655-0990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDONENKO",
"first_name": "ELEONORA",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A65259",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A652590",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1790721850",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.