Individual provider Active NPI

Elsa Ashley Frederic, APRN

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1376933192
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11005206 Issued in FL
Practice address
230 SW 117TH Terrace Unit 103
Pembroke Pines, FL 33025-1054
Phone
(786) 718-3813
NPI assigned
Feb 1, 2015
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11005206 FL Primary

Addresses

Primary practice location

230 SW 117TH Terrace Unit 103
Pembroke Pines, FL 33025-1054

Mailing address

230 SW 117TH Terrace Unit 103
Pembroke Pines, FL 33025-1054
Phone (786) 718-3813

Other practice location 1

8513 Island Breeze Ln
Apt. 208
Temple Terrace, FL 33637-1054
Phone (786) 718-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, MD, IA, CO, TN, OH, CT, DC, NE, NC, NY, MI, IN, NJ, IL, PA, VT, VA, AL20 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 20

Enrollment IDStateProvider typePAC IDDetails
I20220217000350 FL Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 8 organizations
I20231211002909 TX Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20231212003447 MD Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20231213002582 IA Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20231213003226 CO Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20231214001237 TN Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20240202000568 OH Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 4 organizations
I20240227001977 CT Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 4 organizations
I20240408000516 DC Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20240612002018 NE Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20240625000806 NC Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 4 organizations
I20240719001741 NY Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 5 organizations
I20240731004218 MI Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20250106002197 IN Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 3 organizations
I20250107001090 NJ Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 2 organizations
I20250107002756 IL Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20250228001074 PA Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 4 organizations
I20250305000660 VT Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20260514003635 VA Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization
I20260615000435 AL Practitioner - Nurse Practitioner 2163815002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians
Infinite Medical PCGroup PAC ID 8325477656, 87 clinicians
Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians
Dr Rebman Medical PAGroup PAC ID 3678087400, 88 clinicians
Lumina Care Medical NJ LLCGroup PAC ID 6608305156, 60 clinicians

Practice addresses (Care Compare)

100 Abbeyville Rd
Lancaster, PA 17603-4604
Phone (212) 734-6621

101 Walnut St
Neptune, NJ 07753-4301
Phone (718) 534-0689

1010 Carpenters Way
Lakeland, FL 33809-3926
Phone (212) 734-6621

1010 W Main St
Henderson, TX 75652-2923
Phone (718) 534-0689

105 Hospital Dr
Cuero, TX 77954-6400
Phone (718) 534-0689

1100 W Minnesota Rd
Pharr, TX 78577-0163
Phone (718) 534-0689

11041 N 137TH St
Waverly, NE 68462-1022
Phone (212) 734-6621

1108 E Loop
Suite 304
Crockett, TX 75835-1810
Phone (718) 534-0689

1110 Westview Dr
Seymour, TX 76380-3965
Phone (718) 534-0689

1116 E Loop
Suite 304
Crockett, TX 75835-1810
Phone (718) 534-0689

1150 W Dorothy LN
Kettering, OH 45409-1305
Phone (212) 734-6621

11915 27TH Ave
Flushing, NY 11354-1011
Phone (212) 734-6621

1201 Colonel Dr
Garland, TX 75043-1303
Phone (718) 534-0689

1205 Santa Fe Dr
Weatherford, TX 76086-5819
Phone (718) 534-0689

1216 5TH Ave
Youngstown, OH 44504-1605
Phone (718) 534-0689

125 Alma Blvd
Merritt Island, FL 32953-4345
Phone (212) 734-6621

1301 Mesa Dr
Plainview, TX 79072-3905
Phone (718) 534-0689

136 Davis LN
La Follette, TN 37766-3118
Phone (212) 734-6621

13755 Golf Club Pkwy
Fort Myers, FL 33919-5146
Phone (212) 734-6621

1415 Hickory St
Melbourne, FL 32901-3225
Phone (212) 734-6621

1419 Mahlman St
Rosenburg, TX 77471-3911
Phone (718) 534-0689

1430 Pasadena Ave S
Saint Petersburg, FL 33707-3716
Phone (212) 734-6621

150 47TH St SE
Paris, TX 75462-7417
Phone (212) 734-6621

1501 Office Park Rd
West Des Moines, IA 50265-2497
Phone (212) 734-6621

15015 Cypress Wood Medical Dr
Houston, TX 77014-1461
Phone (718) 534-0689

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
76.13
Improvement activities
40
Cost
69.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12884CTMDAddiction (Substance Use Disorder) Counselor
11005206FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Medical Services PC CurrentSince May 19, 2025 Accepting new patients
Dr Rebman BH LLC CurrentSince Nov 3, 2025 Accepting new patients
Fast Doc LLC CurrentSince Jan 31, 2024 Accepting new patients
Daniel Funsch Jr, M.D., P.C. CurrentSince Jun 1, 2025 Accepting new patients
Infinite Medical PC CurrentSince Nov 1, 2023 Accepting new patients
Sun View Medical Services PA CurrentSince Oct 28, 2025 Accepting new patients
Dr Rebman Medical PA CurrentSince Jul 15, 2025 Accepting new patients
Ivy Medical Group PLLC CurrentSince Oct 2, 2024 Accepting new patients
Dr Vezza Medical Services PC CurrentSince Dec 19, 2024 Accepting new patients
Lumina Care Medical NJ LLC CurrentSince Dec 22, 2025 Accepting new patients
Fast Lab Technologies LLC PastSince Dec 1, 2024 Accepting new patients

Locations (25 of 38)

1005 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 482-2523

80 Fern Dr
Torrington, CT 06790
Phone (860) 294-3607

220 Sierra Dr
North Miami Beach, FL 33179
Phone (305) 653-8427

633 NE 167th St
Ste 301
North Miami Beach, FL 33162

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

200 Nassau St N
Venice, FL 34285
Phone (305) 397-8417

1501 Office Park Rd
West Des Moines, IA 50265
Phone (515) 223-1223

6840 W Touhy Ave
Niles, IL 60714
Phone (317) 873-7450

343 S Nappanee St
Elkhart, IN 46514
Phone (574) 295-0096

45 Beachway Dr
Indianapolis, IN 46224
Phone (317) 241-0577

1 Price Dr
Elkton, MD 21921
Phone (410) 398-6474

14200 Laurel Park Dr
Laurel, MD 20707
Phone (301) 953-7980

9200 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 390-2600

22580 W Main St
Armada, MI 48005
Phone (586) 784-5322

310 Pensacola Rd
Burnsville, NC 28714
Phone (828) 682-0200

228 Smith Chapel Rd
Mount Olive, NC 28365
Phone (919) 658-9522

318 W 18th St
#1110
Cozad, NE 69130

25 E Lindsley Rd
Cedar Grove, NJ 07009
Phone (201) 647-8035

101 Walnut St
Neptune City, NJ 07753
Phone (732) 774-2336

418 Broadway
Ste N
Albany, NY 12207
Phone (201) 278-8966

215 Water St
Brooklyn, NY 11201
Phone (917) 503-9404

250 Skillman St
Ste 202
Brooklyn, NY 11205

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (718) 534-0869

11915 27th Ave
Flushing, NY 11354
Phone (631) 681-4754

885 3rd Ave
New York, NY 10022
Phone (212) 906-1200

Interoperability endpoints

  • Direct secure messaging: elsa.frederic@339721039314948.direct.elationemr.com

Organizations & group practices 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1422748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1376933192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SW 117TH TERRACE UNIT 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251054",
            "telephone_number": "786-718-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 SW 117TH TERRACE UNIT 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330251054",
            "telephone_number": "786-718-3813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8513 Island Breeze Ln",
            "address_2": "Apt. 208",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336371054",
            "country_code": "US",
            "telephone_number": "786-718-3813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERIC",
        "first_name": "ELSA",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-01",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.