Patrice R Frederick, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME155086 Issued in FL

Practice address

1290 Waterman Way Ste 1290
Tavares, FL 32778-5229

Phone

(352) 742-0054

NPI assigned

Sep 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Patrice Renee Carter Former name

Medicare fee-for-service enrollment

Enrolled in IL, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Surgery

  Medicare reassignment NPD
• Little Company of Mary Affiliated Services Inc

  dba Little Co of Mary Care Station

  • Urgent Care Clinic/Center
  • Oak Lawn, IL
  • NPI 1033162086
  Medicare reassignment NPD
• Mount Sinai Community Foundation

  dba Sinai Medical Group

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Little Company of Mary Affiliated Services Inc

  dba Little Co of Mary Affiliated

  • Internal Medicine Physician
  • Evergreen Park, IL
  • NPI 1588617260

  Surgery

  NPD
• Mount Sinai Community Foundation

  dba SMG West Care Medical Center

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1891859559
  NPD
• Our Lady of the Lake Physician Group LLC

  dba OLOL Physician Surgical Specialty

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Surgery

  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1225288921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 WATERMAN WAY STE 1290",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-742-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 WATERMAN WAY STE 1290",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785229",
            "telephone_number": "352-742-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 S Wood St Ste 435E",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124325",
            "country_code": "US",
            "telephone_number": "312-355-1493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "PATRICE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036117915",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME155086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117915",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICE",
            "last_name": "CARTER",
            "middle_name": "RENEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Warren Fountain, D.O.
• Moises Fraifeld, MD
• Janith Frances
• Lula M Frazier
• Patricia Ann Frazier, RD LD
• Anja Frederix, A.P.
• David Lewis Frerking, DC
• Shelly Marie Fuchs, LPTA
• Fullsail Therapy Service, LLC
• Functional Billing Associates of Florida Inc.

• Surgery Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.