Jessica Chiyoko Fedor, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3028 Issued in MN

Practice address

9055 Springbrook Dr NW
Coon Rapids, MN 55433

Phone

(763) 780-9155

Fax

(763) 236-1066

NPI assigned

Oct 3, 2006

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfedor448112@excellian.direct.allina.com

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.

• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Allina Health System

  dba Allina Health Isles Clinic

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1386940005
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Allina Health System

  dba Allina Health Nicollet Mall Clinic

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1467758813
  NPD (past)
• Optometric Services, LLC

  • Optometrist
  • Roseville, MN
  • NPI 1518010495
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1801980537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-780-9155",
            "fax_number": "763-236-1066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7545 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Ramsey",
            "state": "MN",
            "postal_code": "553037500",
            "country_code": "US",
            "telephone_number": "612-467-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Highway 10 NE",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "55434",
            "country_code": "US",
            "telephone_number": "763-785-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDOR",
        "first_name": "JESSICA",
        "middle_name": "CHIYOKO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deka Farah
• Daniel McGeary Farber, MD
• Daniel John Farnham, CRNA
• Oladepo Collins Fasoranti, MBBS
• Ashley Fatheree
• Andrew Feld, PHARM.D.
• Carly Felicetta
• Kayla Margaret Felix, MHP, MS
• Stephanie Lane Fennessey, MS, RD, LD, CDE
• Melissa Ferraz de Toledo

• Optometrist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.

Verify at the official NPI Registry.