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

Lexus R Fedorko

Individual provider Nurse Practitioner · NPI 1841160892

Lexus R Fedorko is a Nurse Practitioner in Beachwood, Ohio. Qualified in 2025, 1 year ago. Practices with Id Consultants of Northeast Ohio Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
1
Licensed in
OH
In the registry since
2025
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Practice location Address checks out

3609 Park East Dr Ste 207
Beachwood, OH 44122-4309
Phone: (740) 275-7356
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APR.CNP.0040630 (OH)

Record details

NPI number1841160892
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 6, 2025
Last updated in NPPESNovember 6, 2025
Certification dateOctober 15, 2025
Mailing address1106 Big Sky Blvd Apt 103, Kent, OH 44240-8223

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Id Consultants Of Northeast Ohio Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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