Kevin Frederiks

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

3020943 Issued in MA

Practice address

55 Fruit St
Boston, MA 02114-2696

Phone

(617) 726-9550

NPI assigned

Jun 10, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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.

• Massachusetts General Hospital

  • Psychiatric Hospital
  • Boston, MA
  • NPI 1649111634
  NPD Authorized official

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

{
    "created_epoch": "1781049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1508790072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKS",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-10",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "3020943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlette Lucy Frederick, PT
• David Grant Frederick, MD
• Elisa Smithson Frederick, PNP
• Maureen Frederick, M.D.
• Daniel William Fredericks
• Alyssa Tiana Frederique, PSYD
• Steffany Jane Fredman, PH.D.
• Christopher Fredricks
• Sarah Fredriksson, CRNA
• Jennifer L Freeburn, MS CCC-SLP

• Psychiatry Physician in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.