Individual provider Active NPI

Jeffrey E. Frederic, M.D.

  • Dermatology Physician
  • Baton Rouge, LA
National Provider Identifier
1417997974
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
026034 Issued in LA
Practice address
7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone
(225) 769-4044
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 026034 LA Primary

Addresses

Primary practice location

7373 Perkins Rd
Baton Rouge, LA 70808-4326

Mailing address

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 769-4044

Other identifiers 1

IdentifierTypeStateIssuer
1055026MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060612000091 LA Practitioner - Dermatology 3173535184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baton Rouge Clinic, a Medical CorporationGroup PAC ID 1254317001, 285 clinicians

Practice addresses (Care Compare)

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

7373 Perkins Rd
Baton Rouge, LA 70808-4373

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision137
Removal of skin lesions878
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026034LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation Dermatology CurrentSince Jul 13, 2006 Accepting new patients
Lsuhn Billing LLC CurrentSince Apr 28, 2008 Accepting new patients
Lsuhn Billing LLC CurrentSince Apr 28, 2008 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Jul 13, 2006 Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1417997974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIC",
        "first_name": "JEFFREY",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "026034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055026",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.