Thomas W Frederickson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

26061 Issued in NE

Practice address

7500 Mercy Rd
Omaha, NE 68124-2319

Phone

(402) 343-4328

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

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 2

Specialty

HospitalistAlso: Internal Medicine

Education

University of Minnesota Medical School, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Community Hospital 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health St Mary'S Hospital, Nebraska City, NE, CCN 281342

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Mary'S Community Hospital

  • Critical Access Hospital
  • Nebraska City, NE
  • NPI 1528016995

  NE

  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907

  NE

  Medicare reassignment NPD
• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065

  NE

  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  IA, Internal Medicine

  Medicare reassignment NPD
• St. Mary'S Community Hospital

  • Rural Health Clinic/Center
  • Nebraska City, NE
  • NPI 1851737316
  Care Compare group NPD
• St. Mary'S Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Nebraska City, NE
  • NPI 1497801567
  Care Compare group
• Alegent Health Bergan Mercy Health System

  • Nurse Practitioner
  • Omaha, NE
  • NPI 1982773776
  NPD (past)
• Geriatric Health Services, Inc.

  • Specialist
  • Kansas City, MO
  • NPI 1558387159
  NPD (past)
• Midwest Hospital Specialists, P.a.

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1013901404

  Internal Medicine

  NPD (past)

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

• St. Mary'S Community Hospital

  • Critical Access Hospital
  • Nebraska City, NE
  • NPI 1528016995

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1295728368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242319",
            "telephone_number": "855-524-4001",
            "fax_number": "402-398-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242319",
            "telephone_number": "402-343-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-26524",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "108755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "26061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100293960B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "110199606",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00652380",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "738529",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100293960D",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208471714",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2292243",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23432040",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clara Rose Frederick
• Devin Cole Frederick
• R C- Angel Frederick
• Shae Frederick
• Reva K Fredericksen, OTR/L
• Aaron Fredricks, PHARM.D.
• Sarah Fredrickson
• Theodore A Freeburg, MD
• Traci Freeburg, PTA
• Katlyn Dorothy Freed, BCBA, LBA

• All providers in Omaha, NE
• Internal Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.