Penelope Freseman, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9101742 Issued in FL

Practice address

1701 SE Hillmoor Dr
Suite 5
Port Saint Lucie, FL 34952-7552

Phone

(772) 335-0060

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Alexandra Berger, MD-P.a.

  • Internal Medicine Physician
  • Port St Lucie, FL
  • NPI 1669971453
  NPD (past)
• Allan Birnbaum DO PA

  • Internal Medicine Physician
  • Port St Lucie, FL
  • NPI 1265628861
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366426124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 SW FALCON CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532922",
            "telephone_number": "772-873-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR",
            "address_2": "SUITE 5",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527552",
            "telephone_number": "772-335-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESEMAN",
        "first_name": "PENELOPE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashawn Nathaniel Omari Fraser
• Sarah Frazier, ARNP
• Junette Frazil
• Freedom Home Inc.
• Tyree Jamil Freeman I
• Fresenius Medical Care Comprehensive CKD Services Inc
• Abraham Frias, PT
• Lyle R Fried, CAP, ICADC
• Alexander Friman, APRN
• Frontline Support Coordinators, LLC

• Medical Physician Assistant in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.