Barry L. Frederick, PA-C, MPAS, RN, BSN
Individual provider Active NPI Medical Physician Assistant · Slidell, LA
NPI 1285601740 · NPPES record last updated Apr 22, 2020
Key facts
- NPI
- 1285601740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- Practice address
- 1150 Robert Blvd Ste 240
Slidell, LA 70458-2005 - Phone
- (985) 646-3662
- Fax
- (985) 646-3691
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ochsner Clinic LLC
Practice addresses (Care Compare)
104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211
Hospital & facility affiliations
- Ochsner Medical Center Acute
- Slidell Memorial Hospital
- Ochsner Medical Center-Hancock
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090420000122 | LA | Practitioner - Physician Assistant | 9739172883 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Physician Assistant, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A10586 | LA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic, LLC | Current |
Accepting new patients | |
| Ochsner Clinic LLC | Current |
Accepting new patients | |
| Foucher Emergency Physicians | Physician Assistant | Past | Accepting new patients |
| Louisiana Em-1 Medical Services, a Medical Corporation | Physician Assistant | Past | Accepting new patients |
| Vicksburg Clinic LLC | Past | Accepting new patients | |
| Tchefuncta Emergency Physicians LLC | Physician Assistant | Past | Accepting new patients |
| Louisiana Em-1 Medical Services, PA | Physician Assistant | Past | Accepting new patients |
| Ochsner Clinic LLC | Past | Accepting new patients | |
| Vicksburg Clinic LLC | Past | Accepting new patients | |
| Slidell Memorial Hospital | Past | Accepting new patients |
Locations
104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211
1150 Robert Blvd
Slidell, LA 70458
Phone (985) 280-8823
1150 Robert Blvd
Ste 240
Slidell, LA 70458
Phone (985) 643-7476
1001 Gause Blvd
#75
Slidell, LA 70458
Phone (985) 280-3609
1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | A10586 | LA | |
| Medical Physician Assistant | 363AM0700X | Yes |
Addresses
Primary practice location
1150 Robert Blvd Ste 240
Slidell, LA 70458-2005
Mailing address
1001 Gause Blvd # 75
Slidell, LA 70458-2939
Other practice location 1
1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 649-8542
Other providers in Slidell, LA
- Lauren Franklin
- Rudolph Franklin
- Celia Moseley Franks
- Ariyan Frazier
- Frederick L. Keppel M.D. P.M.C
- Brandi French
- Leigh Ann Freshley
- Patrick M Fried
- Starrann Frisella
- Elizabeth Fruge
All providers in Slidell, LA · Medical Physician Assistant in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.