Individual provider Active NPI

Kathleen M Fryburger, P.A.

  • Physician Assistant
  • Fredericksburg, TX
National Provider Identifier
1053396077
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01528 Issued in TX
Practice address
1308 South Highway 16
Fredericksburg, TX 78624
Phone
(830) 997-2181
Fax
(830) 997-9598
NPI assigned
Dec 13, 2005
Last updated
Dec 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01528 TX Primary

Addresses

Primary practice location

1308 South Highway 16
Fredericksburg, TX 78624

Mailing address

1308 South Highway 16
Fredericksburg, TX 78624
Phone (830) 997-2181

Other identifiers 1

IdentifierTypeStateIssuer
8Y0161OtherTXBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20061011000112 TX Practitioner - Physician Assistant 4183620339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Tracy Byerly II MD PAGroup PAC ID 4082947999, 3 clinicians

Practice addresses (Care Compare)

205 W Windcrest Dr
Suite 210
Fredericksburg, TX 78624-4480

205 W Windcrest St
Fredericksburg, TX 78624-4480
Phone 83099740002057

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.06 of 100Reported as group
Quality
100
Improvement activities
40
Cost
73.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01528TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
STB Medical Consultants, P.a. Current Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1053396077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "78624",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 SOUTH HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "78624",
            "telephone_number": "830-997-2181",
            "fax_number": "830-997-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYBURGER",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8Y0161",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.