NPIMap

Individual provider Active NPI

Carla Anne Frederick, M.D.

  • Pulmonary Disease Physician
  • Buffalo, NY
National Provider Identifier
1093913519
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
256853 Issued in NY
Practice address
100 High St
B8
Buffalo, NY 14203-1126
Phone
(716) 859-2271
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 256853 NY Primary
Pediatrics Physician 208000000X 256853 NY

Addresses

Primary practice location

100 High St
B8
Buffalo, NY 14203-1126

Mailing address

100 High St
B8
Buffalo, NY 14203-1126
Phone (716) 859-2271

Other identifiers 1

IdentifierTypeStateIssuer
03306076MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110418000247 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 0143404053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Academic Medicine Services, Inc.Group PAC ID 0941105241, 115 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

1001 Main St
FL 4
Buffalo, NY 14203-1009
Phone (716) 961-9900

1020 Youngs Rd
Williamsville, NY 14221-2698
Phone (716) 961-9900

462 Grider St
Buffalo, NY 14215-3021

818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 859-5437

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Academic Medicine Services, Inc. CurrentSince Sep 19, 2011 Accepting new patients
University at Buffalo Pediatric Associates Inc Pediatrics PastSince Jan 1, 1998 Accepting new patients
University at Buffalo Surgeons Inc Past Accepting new patients
Kaleida Health Past Accepting new patients

Locations

462 Grider St
Fl 11
Buffalo, NY 14215
Phone (716) 898-4803

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

77 Goodell St
Ste 320
Buffalo, NY 14203

100 High St
#B8
Buffalo, NY 14203
Phone (716) 859-2271

1020 Youngs Rd
Ste 110
Williamsville, NY 14221
Phone (716) 636-8284

1020 Youngs Rd
Williamsville, NY 14221
Phone (716) 636-1600

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1093913519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "address_2": "B8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "address_2": "B8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "CARLA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "256853",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "256853",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03306076",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.