Individual provider Active NPI

Stefan J Friedrichsdorf, MD

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1184632101
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
SFP41 Issued in CA
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-7888
Fax
(612) 813-7199
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X SFP41 CA Primary
Pediatrics Physician 208000000X 48454 MN

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

1975 4TH St
San Francisco, CA 94143-2351
Phone (651) 855-2109

Other identifiers 1

IdentifierTypeStateIssuer
645275200MedicaidMN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200529002301 CA Practitioner - Pediatric Medicine 2466873484 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SFP41CAMDPediatrics Physician
48454MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates Pediatrics CurrentSince May 15, 2020 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco Pediatrics CurrentSince May 15, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 15, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 15, 2020 Accepting new patients
University of California San Francisco CurrentSince May 15, 2020 Accepting new patients
University of California San Francisco Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

3333 California St
San Francisco, CA 94118
Phone (415) 514-3577

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: sfriedrichsdorf125997@direct-ucsfmedicalcenter.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1184632101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "651-855-2109",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-7888",
            "fax_number": "612-813-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICHSDORF",
        "first_name": "STEFAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "SFP41",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "48454",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645275200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.