Individual provider Active NPI

Fredrika Stetson McDonald

  • Audiologist
  • Roseland, NJ
National Provider Identifier
1285891770
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
YA00046000 Issued in NJ
Practice address
556 Eagle Rock Ave
Roseland, NJ 07068-1503
Phone
(073) 226-2262
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X YA00046000 NJ Primary
Audiologist-Hearing Aid Fitter 237600000X MG00077900 NJ

Addresses

Primary practice location

556 Eagle Rock Ave
Roseland, NJ 07068-1503

Mailing address

165 Morris Ave
Mountain Lakes, NJ 07046-1131
Phone (973) 334-3214

Other names 1

  • Rika McDonald Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090205000190 NJ Practitioner - Qualified Audiologist 2961566971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmund S. Liu, MD, PAGroup PAC ID 1254427719, 2 clinicians

Practice addresses (Care Compare)

207 Pompton Ave
Verona, NJ 07044-3018
Phone (973) 571-1933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
YA00046000NJMDAudiologist
MG00077900NJMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Edmund S. Liu, MD, PA CurrentSince Apr 30, 2009 Accepting new patients
West Essex OB-GYN Associates, P.C. PastSince Apr 30, 2009 Accepting new patients
Anthony F. Jahn,M.D.,PA Past Accepting new patients
Englewood Ear Nose & Throat PC PastSince Aug 1, 1997 Accepting new patients

Locations

207 Pompton Ave
Verona, NJ 07044
Phone (973) 239-0052

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1285891770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MORRIS AVE",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461131",
            "telephone_number": "973-334-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 EAGLE ROCK AVE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681503",
            "telephone_number": "073-226-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "FREDRIKA",
        "middle_name": "STETSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "YA00046000",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "MG00077900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RIKA",
            "last_name": "MCDONALD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.