Tiffany Ann Frederickson

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

9138 Issued in SD

Practice address

8412 Kitt Peak Rd
Rapid City, SD 57702-9512

Phone

(515) 201-8982

NPI assigned

Jun 19, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

General Surgery

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Aroostook Medical CenterGroup PAC ID 1153233663, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Light a R Gould Hospital Hospital, Presque Isle, ME, CCN 200018

Merit-based Incentive Payment System (MIPS)

Final score

88.33 of 100Reported as group

Quality

71.56

Promoting interoperability

96

Improvement activities

40

Cost

76.21

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The Aroostook Medical Center

  • Rehabilitation Hospital
  • Presque Isle, ME
  • NPI 1265551212

  Corporate Director

  CMS ownership

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.

• The Aroostook Medical Center

  • General Acute Care Hospital
  • Presque Isle, ME
  • NPI 1396858999
  Medicare reassignment Care Compare group NPD
• The Aroostook Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Presque Isle, ME
  • NPI 1982723037
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Aroostook Medical Center

  • General Acute Care Hospital
  • Presque Isle, ME
  • NPI 1396858999
  Care Compare affiliation

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1265669956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8412 KITT PEAK RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029512",
            "telephone_number": "515-201-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8412 KITT PEAK RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029512",
            "telephone_number": "515-201-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "R-8763",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "TD151001",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "9138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul D Frazer, MD
• Erich Frazeur, CRNA
• Heather Frazeur
• Helen L Frederickson, MD
• Jessica Frederickson, MS, OTR/L
• Mary Ann Fredrickson, LCSW-PIP
• Marisa Win Hoggarth Freeman
• Shaniah Freeseman, CF-SLP
• Virginia Lynn Frei, M.D.
• Mary L Freidel, CSTCFA

• Surgery Physician in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.