Samantha Fredrickson, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

085-009579 Issued in IL

Practice address

6240 W 55TH St
Chicago, IL 60638-2531

Phone

(773) 284-2200

NPI assigned

Jul 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1982783692
  Medicare reassignment Care Compare group
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1275605792
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1699701383
  NPD

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1023799939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W JACKSON BLVD APT 816",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382531",
            "telephone_number": "773-284-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "085-009579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Karl Frederiksen, M.D., PH.D.
• Janea Fredia
• Allan J Fredland, M.D.
• Fredric J. Levy, M.D.,S.C.
• Earl E Fredrick, M.D.
• Free Body Physical Therapy Professional Corporation
• Free Covid Care
• Free Minded Counseling PLLC
• Free to Be Therapy
• Alan Free, M.D.

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.