Individual provider Active NPI

Freda Musial, NP

  • Nurse Practitioner
  • Honesdale, PA
National Provider Identifier
1255310231
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704150548 Issued in MI
Practice address
601 Park St
Emergency Dept
Honesdale, PA 18431-1445
Phone
(570) 253-8140
Fax
(866) 250-6385
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704150548 MI Primary
Nurse Practitioner 363L00000X 0024167850 VA
Nurse Practitioner 363L00000X SP009678 PA

Addresses

Primary practice location

601 Park St
Emergency Dept
Honesdale, PA 18431-1445

Mailing address

38935 Ann Arbor Rd
Suite 201
Livonia, MI 48150-3354
Phone (734) 632-0175

Other identifiers 1

IdentifierTypeStateIssuer
11712562OtherPACAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20060126000989 MI Practitioner - Nurse Practitioner 1052325297 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704150548MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Michigan, P.C. CurrentSince May 1, 2014 Accepting new patients
Epmg of Michigan, P.C. Nurse Practitioner PastSince Aug 4, 2024 Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1255310231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "address_2": "SUITE 201",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503354",
            "telephone_number": "734-632-0175",
            "fax_number": "734-632-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PARK ST",
            "address_2": "EMERGENCY DEPT",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311445",
            "telephone_number": "570-253-8140",
            "fax_number": "866-250-6385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSIAL",
        "first_name": "FREDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704150548",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024167850",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP009678",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11712562",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

Verify at the official NPI Registry.