Active NPI
Stephanie H Fretz, MD
- Pediatrics Physician
- Buffalo, NY
National Provider Identifier
1033217666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 200115
- Practice address
- 899 Main St
Buffalo, NY 14203-1109 - Phone
- (716) 878-2700
- Fax
- (716) 878-2701
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 200115 | NY | Primary |
Addresses
Primary practice location
899 Main St
Buffalo, NY 14203-1109
Mailing address
120 Gardenville Pkwy W
Attn: Credentialing
West Seneca, NY 14224-1324
Phone (716) 857-6150
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040426001735 | Other | NY | FIDELIS |
| 00010057901 | Other | NY | UNIVERA |
| 01650600 | Medicaid | NY | |
| 000523863001 | Other | NY | BC/BS |
| 1207908 | Other | NY | INDEPENDENT HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070911000788 | NY | Practitioner - Pediatric Medicine | 6709979479 | Practice locations: West Seneca, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedar Pediatrics PLLC | Current | Accepting new patients |
Locations
1010 Main St
Ste 110
Buffalo, NY 14202
Interoperability endpoints
- sfretz@pedsurgentcare.medentdirect.com
- drfretz@cedarpediatrics.medentdirect.com
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Buffalo, NY
- NPI 1639685464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263168000000",
"number": "1033217666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 GARDENVILLE PKWY W",
"address_2": "ATTN: CREDENTIALING",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142241324",
"telephone_number": "716-857-6150",
"fax_number": "716-656-4074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "899 MAIN ST",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142031109",
"telephone_number": "716-878-2700",
"fax_number": "716-878-2701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRETZ",
"first_name": "STEPHANIE",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2010-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "200115",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "040426001735",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00010057901",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01650600",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "000523863001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "1207908",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.