Individual provider Active NPI

Renee A Frederickson, M.D.

  • Obstetrics & Gynecology Physician
  • Bozeman, MT
National Provider Identifier
1528039930
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
69114 Issued in MT
Practice address
905 Highland Blvd
Suite 4500
Bozeman, MT 59715-6903
Phone
(406) 414-5150
Fax
(406) 414-5175
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 69114 MT Primary

Addresses

Primary practice location

905 Highland Blvd
Suite 4500
Bozeman, MT 59715-6903

Mailing address

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

Other identifiers 1

IdentifierTypeStateIssuer
1528039930MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rfrederickson13158960@direct.sanfordhealth.org Direct Bozeman Health Deaconess Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20190531001933 MT Practitioner - Obstetrics/Gynecology 5698700508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northwestern University Feinberg Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bozeman Health Deaconess HospitalGroup PAC ID 4688984164, 309 clinicians

Practice addresses (Care Compare)

905 Highland Blvd
Suite 4500
Bozeman, MT 59715-6903
Phone (406) 414-5150

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

925 Highland Blvd
Bozeman, MT 59715-6900

925 Highland Blvd
Suite 1220
Bozeman, MT 59715-6905
Phone (406) 414-3780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
72.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69114MTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital CurrentSince Jun 1, 2019 Accepting new patients
Bozeman Health Deaconess Hospital Obstetrics & Gynecology CurrentSince Jun 1, 2019 Accepting new patients
Belgrade Clinic PLLP Current Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients

Locations

905 Highland Blvd
Ste 4500
Bozeman, MT 59715
Phone (406) 414-5150

925 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-3780

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

905 Highland Blvd
Ste 4440
Bozeman, MT 59715
Phone (406) 414-5150

Interoperability endpoints

  • Direct secure messaging: rfrederickson13158960@direct.sanfordhealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1528039930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HIGHLAND BLVD",
            "address_2": "SUITE 4500",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156903",
            "telephone_number": "406-414-5150",
            "fax_number": "406-414-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSON",
        "first_name": "RENEE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MT",
            "license": "69114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528039930",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfrederickson13158960@direct.sanfordhealth.org",
            "affiliation": "Y",
            "affiliationName": "Bozeman Health Deaconess Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "905 Highland Blvd",
            "address_2": "Suite 4500",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597156903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.