NPIMap

Individual provider Active NPI

Rebecca A Fredrick, DO

  • Family Medicine Physician
  • Rocky River, OH
National Provider Identifier
1346449014
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-009134 Issued in OH
Practice address
19800 Detroit Rd
Rocky River, OH 44116-1816
Phone
(440) 333-1107
Fax
(440) 333-1064
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-009134 OH Primary

Addresses

Primary practice location

19800 Detroit Rd
Rocky River, OH 44116-1816

Mailing address

26908 Detroit Rd
Suite 301
Westlake, OH 44145-2398
Phone (440) 617-1823

Other identifiers 1

IdentifierTypeStateIssuer
2887961MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebeccafredrick@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080916000322 OH Practitioner - Family Practice 5890862940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137
  • Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-009134OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Family Medicine CurrentSince Jan 1, 2017 Accepting new patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Jan 1, 2017 Accepting new patients
University Primary Care Practices Past Accepting new patients

Locations

2535 Hale St
Ste B
Avon, OH 44011
Phone (440) 934-8858

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: rfredrick37229@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 7

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1346449014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26908 DETROIT RD",
            "address_2": "SUITE 301",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441452398",
            "telephone_number": "440-617-1823",
            "fax_number": "440-617-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19800 DETROIT RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161816",
            "telephone_number": "440-333-1107",
            "fax_number": "440-333-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-009134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2887961",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebeccafredrick@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "19800 Detroit Rd",
            "city": "Rocky River",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441161816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

Verify at the official NPI Registry.