LYDIA HELEN NEFEDOV MSN, AGNP-BC
NPI 1902349772
Nurse Practitioner - Acute Care in San Antonio, TX

Q: What is Lydia Nefedov's NPI number?

The NPI number for Lydia Nefedov is 1902349772. It was assigned to this individual provider in the NPPES registry on November 28, 2016.

Q: What is Lydia Nefedov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Lydia Nefedov was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since November 28, 2016PECOS EnrolledAccepts Medicare Assignment

3463 MAGIC DR STE T21, SAN ANTONIO, TX 78229(210) 614-8101 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2026, Aug 10, 2023, Sep 20, 2022 and 2 more (5 updates tracked since 2018).

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About Lydia Helen Nefedov Msn, Agnp-bc NPPES

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

LYDIA HELEN NEFEDOV MSN, AGNP-BC (NPI 1902349772) is an individual acute care provider in San Antonio, Texas, licensed in Ohio (APRN.CNP.0040200) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS, is affiliated with Indiana University Health Bloomington Hospital, and maintains a secondary practice location in Kettering.

NPPES Registry Identity

NPI1902349772

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameLYDIA HELEN NEFEDOVCredential: MSN, AGNP-BC

Location Address3463 MAGIC DR STE T21San Antonio, TX 78229-3621

Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959

Phone(210) 614-8101

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateNovember 28, 2016

Last NPPES UpdateMarch 11, 20265 updates tracked since enumeration

NPPES CertifiedMarch 11, 2026

✔ NPI 1902349772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

Licenses✔ Licensed in OH · APRN.CNP.0040200✔ Licensed in TX · 1075580

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License APRN002369 (NV), 71013911A (IN)

3463 MAGIC DR STE T21, San Antonio, TX 78229

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Secondary Practice Location 1

Location 13533 Southern Blvd Ste 5650Kettering, OH 45429-1263 · Phone (937) 294-3611

Other Identifiers 1

Other090540884IN · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Blue Cross Blue Shield of North Dakota, CareSource and more.Insurance ›

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

Lydia Helen Nefedov Msn, Agnp-bc 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.

PECOS PAC ID5092096206

PECOS Enrollment IDI20230714001643, I20251027001740, I20260115000122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health Bloomington Hospital

Acute Care Hospitals · Bloomington, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150051

Location2651 East Discovery ParkwayBloomington, IN 47408 · Monroe County

Emergency services Birthing friendly

Ascension NE Wisconsin - St Elizabeth Campus

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520009

Location1506 S Oneida StAppleton, WI 54915 · Outagamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78229 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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 16

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

ALVIN E HARTMANN CCP, LP

Perfusionist