Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dimitri Fedorov, PA

Individual provider Medical Physician Assistant · NPI 1275495046

Dimitri Fedorov, PA is a Physician Assistant in Brooklyn, New York. Practices with Vanguard Dermatology, a 10-clinician group and accepts Medicare assignment. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2148 Ocean Ave Fl 5
Brooklyn, NY 11229-1484
Phone: (212) 398-1288
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1275495046
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 1, 2025
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2026 (0 years in practice)
Group practice Vanguard Dermatology — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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