Individual provider Active NPI

Ruth Friedrichsdorf, M.D.

  • Pediatrics Physician
  • Mill Valley, CA
National Provider Identifier
1447686985
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A166767 Issued in CA
Practice address
61 Camino Alto Ste 107
Mill Valley, CA 94941-2910
Phone
(415) 388-6303
Fax
(415) 388-7136
NPI assigned
Sep 16, 2013
Last updated
Aug 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A166767 CA Primary
Pediatrics Physician 208000000X 60208 MN

Addresses

Primary practice location

61 Camino Alto Ste 107
Mill Valley, CA 94941-2910

Mailing address

31 Sunrise Ave
Mill Valley, CA 94941-3338
Phone (612) 666-2096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160318000015 MN Practitioner - Pediatric Medicine 9931406949 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166767CAMDPediatrics Physician
60208MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Single Specialty Current Accepting new patients
Fairview Clinics Single Specialty Current Accepting new patients
Fairview Clinics CurrentSince Feb 14, 2016 Accepting new patients
Fairview Clinics CurrentSince Feb 14, 2016 Accepting new patients
Fairview Health Services CurrentSince May 1, 2016 Accepting new patients
University of California, San Francisco Past Accepting new patients
Golden Gate Pediatrics, a Medical Corporation Single Specialty Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2535 University Ave SE
Minneapolis, MN 55414
Phone (612) 672-2350

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: rfriedrichsdorf@ggp.pcc-direct.com
  • Direct secure messaging: rfriedrichsdorf129640@direct-ucsfmedicalcenter.org
  • Direct secure messaging: rfriedrichsdorf557963@hisp.ehr.sutterhealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1447686985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SUNRISE AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413338",
            "telephone_number": "612-666-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CAMINO ALTO STE 107",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412910",
            "telephone_number": "415-388-6303",
            "fax_number": "415-388-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICHSDORF",
        "first_name": "RUTH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A166767",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "60208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.