KELLY ANNE FEDORUK MD
NPI 1568093045
Anesthesiology in Palo Alto, CA
About Kelly Anne Fedoruk Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY ANNE FEDORUK MD (NPI 1568093045) is an individual anesthesiology provider in Palo Alto, California, licensed in California (A144015) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Stanford, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelly Anne Fedoruk Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
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 Kelly Fedoruk's NPI number?
The NPI number for Kelly Fedoruk is 1568093045. It was assigned to this individual provider in the NPPES registry on February 3, 2020.
Where is Kelly Fedoruk located?
Kelly Fedoruk practices at 725 Welch Rd, Palo Alto, CA 94304. The listed phone number is (650) 497-8000.
What is Kelly Fedoruk's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Kelly Fedoruk enrolled in Medicare?
Yes. Kelly Fedoruk is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Kelly Fedoruk was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Kelly Anne Fedoruk, MD · NPI 1568093045
Anesthesiology physician in Palo Alto, California. Individual provider, active in the CMS NPPES registry since February 3, 2020.
## Identity
- **NPI:** 1568093045 (Entity type: Individual)
- **Enumerated:** February 3, 2020
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** A144015 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 725 WELCH RD, Palo Alto, CA 94304-1601
- **Phone:** (650) 497-8000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** April 10, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1568093045) · Data from the CMS NPPES public registry.