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LORI FEDORONKO M D P C
NPI 1265633416
Dermatology - Procedural Dermatology in Troy, MI

Active since May 29, 2007CLIA 23D0686049 · Microscopy
1350 KIRTS BLVD, SUITE 155, TROY, MI 48084(248) 362-0222 Get Directions Write a Review

NPPES record last updated: July 1, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lori Fedoronko M D P C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LORI FEDORONKO M D P C (NPI 1265633416) is a healthcare organization registered as a procedural dermatology in Troy, Michigan and active in the NPI registry since May 2007. The organization holds a CLIA Microscopy certificate valid through September 2, 2026 and lists Lori Fedoronko, President, as its authorized official.

NPPES Registry Identity

NPI1265633416
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameLORI FEDORONKO M D P C
Location Address1350 KIRTS BLVD, SUITE 155Troy, MI 48084-4851
Mailing Address1350 Kirts Blvd, Suite 155Troy, MI 48084-4851 · (248) 362-0222
Phone(248) 362-0222
Organization SubpartNo
Authorized OfficialLori FedoronkoPresident · (248) 362-0222
Enumeration DateMay 29, 2007
Last NPPES UpdateJuly 1, 2016
✔ NPI 1265633416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in MI · LF064064
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
1350 KIRTS BLVD, Troy, MI 48084
Open in Google Maps ↗

Other Identifiers 2

Medicaid3415994MI
Medicare PING56093MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0686049

Lori Fedoronko MD PC · Troy, MI
Active · expires Sep 2, 2026
CLIA Number23D0686049
Laboratory TypePhysician Office
Certificate Effective DateSeptember 3, 2024
Certificate Expiration DateSeptember 2, 2026
Laboratory DirectorLori M. Fedoronko
Laboratory Phone(248) 362-0222
Laboratory LocationLori Fedoronko MD PC1350 Kirts Blvd #155, Troy, MI 48084
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONALD M KNAPKE MD PC
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-9426
ZACHARY J ENDRESS JR MD PC
Orthopaedic Surgery
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-9426
CHRISTINA ENDRESS MD PC
Orthopaedic Surgery (Hand Surgery)
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-9426
MICHAEL A FLIERL, MD PC
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-8431
DESAREE M CARWILE OTR CHT
Occupational Therapist
1350 KIRTS BLVD
TROY, MI 48084
Oakland County (248) 519-4900
GREGORY A ZEMENICK MD PC
Orthopaedic Surgery
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-9426
DR. KATHARINE W MAUER MD
Allergy & Immunology
1350 KIRTS BLVD, STE 140
TROY, MI 48084
Oakland County (248) 269-8529
GREGORY P. NOWINSKI MD PC
Orthopaedic Surgery (Orthopaedic Trauma)
1350 KIRTS BLVD, SUITE 160
TROY, MI 48084
Oakland County (248) 244-9426

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lori Fedoronko M D P C's NPI number?

The NPI number for Lori Fedoronko M D P C is 1265633416. It was assigned to this organization in the NPPES registry on May 29, 2007.

Where is Lori Fedoronko M D P C located?

Lori Fedoronko M D P C is located at 1350 Kirts Blvd Suite 155, Troy, MI 48084. The listed phone number is (248) 362-0222.

What is Lori Fedoronko M D P C's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Does Lori Fedoronko M D P C hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0686049) is associated with this NPI, valid through September 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lori Fedoronko M D P C accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lori Fedoronko M D P C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lori Fedoronko M D P C was last updated on July 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.