NICHOLAS PETER FEDOR (PA-C) – Physician Assistant, NPI 1699103804
Physician Assistant
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,118 PHYSICIAN ASSISTANT in TN
Provider Addresses for NICHOLAS PETER FEDOR (PA-C)
10820 Parkside Dr
Emergency Dept.
Knoxville, TN 379341956
Phone: (865) 988-3666
Type: Location
10820 PARKSIDE DR
EMERGENCY DEPT.
KNOXVILLE, TN 379341956
Phone: (865) 988-3666
Type: Location
PO BOX 1008
LENOIR CITY, TN 377711008
Phone: (865) 988-3666
Type: Mailing
1907 BORDER AVE
TORRANCE, CA 905013606
Phone: (844) 443-6246
Fax: (833) 907-2235
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-12-31 (892 days ago).
Enrollment records
11
Earliest due date
2023-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131219001101 | I | Physician Assistant | TN | 2023-12-31 |
| I20240424000328 | I | Physician Assistant | DC | TBD |
| I20240426003408 | I | Physician Assistant | VA | TBD |
| I20240516000916 | I | Physician Assistant | CO | TBD |
| I20240710002041 | I | Physician Assistant | NC | TBD |
| I20240816000891 | I | Physician Assistant | AZ | TBD |
| I20241003001578 | I | Physician Assistant | TX | TBD |
| I20250114003098 | I | Physician Assistant | CA | TBD |
| I20250116001208 | I | Physician Assistant | NY | TBD |
| I20251006000407 | I | Physician Assistant | MI | TBD |
| I20251203004531 | I | Physician Assistant | NJ | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99342 | Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes | 57 | 57 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 48 | 25 | $0 |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 43 | 41 | $0 |
| 85014 | Red blood cell concentration measurement | 42 | 42 | $0 |
| 80047 | Blood test, basic group of blood chemicals (calcium, ionized) | 42 | 42 | $0 |
Insurance plans in this area (ZIP 37934)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TN | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Physician Assistant | NY | |
| Nurse Practitioner | TN | |
| Emergency Medicine, Internal Medicine | NY | |
| Nurse Practitioner | NY | |
| Physician Assistant | NY | |
| Physician Assistant | CT | |
| Physician Assistant | NY |
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