Active NPI
Fredric M Mintzer, M.D.
- Psychiatry Physician
- Penndel, PA
National Provider Identifier
1407859960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD022742E
- Practice address
- 1517 Durham Rd
Penndel, PA 19047-5707 - Phone
- (215) 752-1541
- Fax
- (215) 752-7195
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD022742E | PA | Primary |
Addresses
Primary practice location
1517 Durham Rd
Penndel, PA 19047-5707
Mailing address
4041 S Warner Rd
Lafayette Hill, PA 19444-1421
Phone (610) 828-4428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1407859960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4041 S WARNER RD",
"city": "LAFAYETTE HILL",
"state": "PA",
"postal_code": "194441421",
"telephone_number": "610-828-4428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 DURHAM RD",
"city": "PENNDEL",
"state": "PA",
"postal_code": "190475707",
"telephone_number": "215-752-1541",
"fax_number": "215-752-7195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTZER",
"first_name": "FREDRIC",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD022742E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penndel, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.