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DR. IRENA MORIN FEDOROVSKY PSY.D.
NPI 1346623576
Psychologist - Clinical in Fairfax, VA

Active since July 07, 2015Opted out of Medicare · through Dec 10, 2026
3040 WILLIAMS DR, SUITE # 402, FAIRFAX, VA 22031(703) 573-3573(703) 573-3574 Get Directions Write a Review

NPPES record last updated: July 7, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Irena Morin Fedorovsky Psy.d. NPPES

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

DR. IRENA MORIN FEDOROVSKY PSY.D. (NPI 1346623576) is an individual clinical provider in Fairfax, Virginia, licensed in Virginia (0810005119) and active in the NPI registry since July 2015. She has opted out of Medicare through December 10, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1346623576
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. IRENA MORIN FEDOROVSKYCredential: PSY.D.
Location Address3040 WILLIAMS DR, SUITE # 402Fairfax, VA 22031-4618
Mailing Address3040 Williams Dr, Suite # 402Fairfax, VA 22031-4618 · (703) 573-3573 · Fax (703) 573-3574
Phone(703) 573-3573
Fax(703) 573-3574
Sole ProprietorYes
Enumeration DateJuly 7, 2015
✔ NPI 1346623576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in VA · 0810005119✔ Licensed in MD · 05524✔ Licensed in DC · PSY1001033
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
3040 WILLIAMS DR, Fairfax, VA 22031
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Irena Morin Fedorovsky Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 10, 2020 through December 10, 2026.

Opt-Out Effective DateDecember 10, 2020
Opt-Out In Effect ThroughDecember 10, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22031 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$194.86 typical visit price
range $65.18 – $194.86
Typical copayment $48.71 (range $16.29 – $48.71)
Most-billed visit code 99205
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

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

BARRY B EKDOM PHD, PC
Clinical Neuropsychologist
3040 WILLIAMS DR, SUITE 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3575
DR. MICHELLE SULLIVAN-GAST PSY.D.
Psychologist (Clinical)
3040 WILLIAMS DR, SUITE 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3573
NANA DICKSON, DDS PC
Dentist
3040 WILLIAMS DR, SUITE #201
FAIRFAX, VA 22031
Fairfax County (571) 419-6897
DR. BARRY B. EKDOM PH.D.
Clinical Neuropsychologist
3040 WILLIAMS DR, SUITE 402
FAIRFAX, VA 22031
Fairfax County (703) 573-3573
DR. NANA DICKSON D.D.S.
Dentist (General Practice)
3040 WILLIAMS DR, STE. #201
FAIRFAX, VA 22031
Fairfax County (571) 419-6897

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 Irena Fedorovsky's NPI number?

The NPI number for Irena Fedorovsky is 1346623576. It was assigned to this individual provider in the NPPES registry on July 7, 2015.

Where is Irena Fedorovsky located?

Irena Fedorovsky practices at 3040 Williams Dr Suite # 402, Fairfax, VA 22031. The listed phone number is (703) 573-3573.

What is Irena Fedorovsky's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Irena Fedorovsky enrolled in Medicare?

No. Irena Fedorovsky has opted out of Medicare through December 10, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Irena Fedorovsky was last updated on July 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.