Amanda N Fredette, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01108 Issued in RI

Practice address

102 Valley Rd
Middletown, RI 02842-5237

Phone

(401) 239-1800

Fax

(401) 239-1801

NPI assigned

Mar 15, 2019

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 RI

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

Emory University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspire Dermatology LLCGroup PAC ID 1759550643, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Merit-based Incentive Payment System (MIPS)

Final score

90.23 of 100Reported as group

Quality

95.87

Promoting interoperability

100

Improvement activities

40

Cost

71.56

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Aspire Dermatology LLC

  • MOHS-Micrographic Surgery Physician
  • Middletown, RI
  • NPI 1700176849
  Medicare reassignment Care Compare group
• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629
  NPD (past)

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

• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1083173421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425237",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425237",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Wampanoag Trl Ste 203",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "RI",
            "postal_code": "029151038",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "851 Main St",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "RI",
            "postal_code": "028854402",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862717",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 William S Canning Blvd",
            "address_purpose": "LOCATION",
            "city": "Tiverton",
            "state": "RI",
            "postal_code": "028783003",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1524 Atwood Ave Ste 321",
            "address_purpose": "LOCATION",
            "city": "Johnston",
            "state": "RI",
            "postal_code": "029193228",
            "country_code": "US",
            "telephone_number": "401-239-1800",
            "fax_number": "401-239-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "AMANDA",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forest Farm Health Care Center I LLC
• Sherri Lynne Fournier, RN
• Emily Fowler, LMHC
• Jacob Francis, FNP-C
• Peter Gregory Frazier, D.D.S.
• Steven Franklin Freedman, M.D.
• Francesca Friel, NP
• Michelle Fuleky
• David Roy Gabriel, O.D.
• Pamela Gadbaw, FNP-C

• Physician Assistant in Middletown, RI
• Providers in Middletown, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.