Bruce E Fredrickson, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

122366 Issued in NY

Practice address

550 Harrison St
Ste 130
Syracuse, NY 13202-3064

Phone

(315) 464-4472

Fax

(315) 464-5223

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• Murray and Wray

  • Orthopaedic Surgery Physician
  • Manlius, NY
  • NPI 1285740613
  NPD (past)
• Upstate Orthopedics, LLP

  • Durable Medical Equipment & Medical Supplies
  • Camillus, NY
  • NPI 1871290445

  Orthopaedic Surgery

  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1477558492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HARRISON ST",
            "address_2": "STE 130",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023064",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HARRISON ST",
            "address_2": "STE 130",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023064",
            "telephone_number": "315-464-4472",
            "fax_number": "315-464-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "BRUCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NY",
            "license": "122366",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "122366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00522514",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "122366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristeen Rhoda-Marie Frazier
• Nancy M Frazier, LCSW
• Y'Londa Lynise Frazier, CASAC-P
• Isaac Vincenzo Frechette
• Vincent E Frechette, MD
• Maxine Free, RN
• Katharine Marie Freeborn, A-GNP-C
• Jordan Andrew Freed
• Jourdan H Freed, D.D.S.
• Alexandra Freeman, M.D.

• Orthopaedic Surgery of the Spine Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Orthopaedic Surgery of the Spine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.