Brian Paul Fedoronko, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301063578 Issued in MI

Practice address

24 Frank Lloyd Wright Dr
Suite L 2200
Ann Arbor, MI 48105-9484

Phone

(734) 930-4020

Fax

(734) 769-8948

NPI assigned

Aug 3, 2006

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

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

Interoperability endpoints

• Direct secure messaging: brian.fedoronko.2@11144.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/11144/brand/1/csg/1/fhir/r4

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.

• Emmaus Health Partners

  • Multi-Specialty Clinic/Center
  • Ann Arbor, MI
  • NPI 1851870653

  Internal Medicine

  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1962410290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "SUITE L 2200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-930-4020",
            "fax_number": "734-769-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "SUITE L 2200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-930-4020",
            "fax_number": "734-769-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORONKO",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063578",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301063578",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Anne Fecher, M.D.
• Erin M. Fedak Romanowski, D.O.
• Robert Edward Fedchenko, DDS
• Karen Ann Feddersen, RN
• Abigail Fedewa, LMSW
• Joseph Feege III
• Nancy Feege
• Tate Feeney
• Steven David Fegan, DDS
• Darius Sergiu Feier

• Internal Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.