Individual provider Active NPI

Eric Feduska

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1801234117
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OS018723 Issued in PA
Practice address
111 S 11TH St Ste 8490
Philadelphia, PA 19107-4824
Phone
(215) 955-6161
Fax
(215) 923-5507
NPI assigned
Jun 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X OS018723 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste 8490
Philadelphia, PA 19107-4824

Mailing address

111 S 11TH St Ste 8280
Philadelphia, PA 19107-4824
Phone (215) 955-2370

Other practice location 1

900 Walnut St
Philadelphia, PA 19107-5191
Phone (215) 955-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190730000152 PA Practitioner - Anesthesiology 8123251220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

900 Walnut St
Philadelphia, PA 19107
Phone (215) 503-8080

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

111 S 11th St
Ste 8280
Philadelphia, PA 19107
Phone (215) 955-2370

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1801234117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8280",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-2370",
            "fax_number": "215-955-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075191",
            "country_code": "US",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDUSKA",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OS018723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.