Robert E Fredricks, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G86902 Issued in CA

Practice address

1000 Vale Terrace Dr
Vista, CA 92084-5218

Phone

(760) 631-5000

Fax

(760) 414-3713

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: robert.fredricks.p1@direct.vistacommunityclinic.nextgenshare.com

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.

• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD (past)
• Tri-City Hospital

  dba Tri-City Medical Center

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  NPD (past)
• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1649363375
  NPD (past)
• Flagstaff Medical Center

  dba FMC Behavioral Health Services

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1073524492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKS",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G86902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "FHC70267F",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Ronald Francis, PH.D
• Araceli Luz Franco-Miranda, PTA
• Lizette Franks
• Ashley Frechette, MPH, RDN
• John Edward Fredette, LMFT
• Kathryn Woodward Fredrickson, LMFT
• Mikayla Elise Freed
• Katherine Joy Freeman, MFT
• Kerry Hasty Freeman
• Carla French-Zeledon

• Pediatrics Physician in Vista, CA
• Providers in Vista, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.

Verify at the official NPI Registry.