Matthew Jared Fradkin, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60663357 Issued in WA

Practice address

2211 Queen Anne Ave N
Seattle, WA 98109-2367

Phone

(206) 861-8500

Fax

(206) 861-8501

NPI assigned

Mar 16, 2012

Last updated

Oct 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.fradkin.1@29210.direct.athenahealth.com
• Direct secure messaging: mfradkin1037872@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Puffin Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Seattle, WA
  • NPI 1487345757
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1013282581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 QUEEN ANNE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092367",
            "telephone_number": "206-861-8500",
            "fax_number": "206-861-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRADKIN",
        "first_name": "MATTHEW",
        "middle_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-16",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A135505",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60663357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfradkin1037872@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2211 Queen Anne Ave N",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981092367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clarissa B Foy, ANP, ARNP
• Hugh M Foy, MD
• Tasha Foy, RN
• Trayvon Edward Foy, DDS
• Amelia Foyle, PHARMD
• Ralph A. Fragale, MA, LMHC
• Stephanie Marie Fragoso Reyes
• Cathlyn Marie Fraguela Rios, LICSW
• Jami Renae Fraissinet
• Sarah Deann Fraker, DDS

• Pediatrics Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.