NPIMap

Individual provider Active NPI

Barry L. Frederick, PA-C, MPAS, RN, BSN

  • Medical Physician Assistant
  • Slidell, LA
National Provider Identifier
1285601740
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 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
Last updated
Apr 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X A10586 LA
Medical Physician Assistant 363AM0700X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090420000122 LA Practitioner - Physician Assistant 9739172883 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Physician Assistant, Registered Nurse

State licenses

LicenseStateTypeSpecialty
A10586LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Feb 18, 2019 Accepting new patients
Ochsner Clinic, LLC CurrentSince Feb 18, 2019 Accepting new patients
Foucher Emergency Physicians Physician Assistant Past Accepting new patients
Louisiana Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
Tchefuncta Emergency Physicians LLC Physician Assistant Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Slidell Memorial Hospital 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
Vicksburg Clinic LLC Past Accepting new patients

Locations

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

1001 Gause Blvd
#75
Slidell, LA 70458
Phone (985) 280-3609

1150 Robert Blvd
Slidell, LA 70458
Phone (985) 280-8823

1150 Robert Blvd
Ste 240
Slidell, LA 70458
Phone (985) 643-7476

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1285601740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD # 75",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD STE 240",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582005",
            "telephone_number": "985-646-3662",
            "fax_number": "985-646-3691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Gause Blvd",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704582939",
            "country_code": "US",
            "telephone_number": "985-649-8542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "BARRY",
        "middle_name": "L.",
        "credential": "PA-C, MPAS, RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "A10586",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.