Individual provider Active NPI

Adam Randall Frederick, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1184809949
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD172961 Issued in OR
Practice address
2501 NE Century Blvd
Hillsboro, OR 97124-5506
Phone
(971) 214-8422
Fax
(971) 214-8607
NPI assigned
Dec 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD172961 OR Primary

Addresses

Primary practice location

2501 NE Century Blvd
Hillsboro, OR 97124-5506

Mailing address

2501 NE Century Blvd
Ms: Ra3-113
Hillsboro, OR 97124-5506
Phone (971) 214-8422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109537CAMDGeneral Practice Dentistry
A109537CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine Past Accepting new patients
University Primary Care Sports Med Past Accepting new patients

Organizations & group practices 2

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": "1198886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1184809949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 NE CENTURY BLVD",
            "address_2": "MS: RA3-113",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245506",
            "telephone_number": "971-214-8422",
            "fax_number": "971-214-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 NE CENTURY BLVD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245506",
            "telephone_number": "971-214-8422",
            "fax_number": "971-214-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "ADAM",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-29",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD172961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.