Viktor Vasilyevich Fedorov, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2024-01637 Issued in NC

Practice address

255 Memorial Dr
Jacksonville, NC 28546-6333

Phone

(910) 353-7848

NPI assigned

Apr 3, 2016

Last updated

Dec 27, 2024By 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 2

Addresses

Other names 1

• Viktor Vasilyevich Stankovich Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

General Surgery

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Onslow Ambulatory Services IncGroup PAC ID 4587569256, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

Merit-based Incentive Payment System (MIPS)

Final score

89.53 of 100Reported as group

Quality

90.05

Promoting interoperability

100

Improvement activities

40

Cost

75.04

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vfedorov1061111@direct.novanthealth.org

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.

• Onslow Ambulatory Services, Inc.

  dba Central Coast Dermatology

  • Dermatology Physician
  • Jacksonville, NC
  • NPI 1033306279
  Medicare reassignment Care Compare group NPD
• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Medicare reassignment NPD
• Onslow Ambulatory Services, Inc.

  • Clinic/Center
  • Jacksonville, NC
  • NPI 1356692065
  NPD
• Onslow Ambulatory Services, Inc.

  dba Onslow Surgical Clinic

  • Surgery Physician
  • Jacksonville, NC
  • NPI 1558776997
  NPD

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

• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Care Compare affiliation

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1861855140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466333",
            "telephone_number": "910-353-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466333",
            "telephone_number": "910-353-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Western Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466379",
            "country_code": "US",
            "telephone_number": "910-577-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDOROV",
        "first_name": "VIKTOR",
        "middle_name": "VASILYEVICH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-03",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "218430",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2024-01637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIKTOR",
            "last_name": "STANKOVICH",
            "middle_name": "VASILYEVICH",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fayetteville Vamc
• Fayetteville Vamc
• Fayetteville Vamc
• Fayetteville Vamc
• Jadyn Fedah
• Kathleen Elizabeth Fee, CLD, LC
• Feeling Great, Inc. (Second Breath)
• Marjorie Ann Feely, RN
• Arla Fehr
• Willa J. Feldhaus, LCSW

• Surgery Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.