Individual provider Active NPI

Joel Frederick, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1578791224
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301094966 Issued in MI
Practice address
3990 John R
Anesthesia Education Offices 2901
Detroit, MI 48201
Phone
(313) 745-7233
Fax
(313) 993-3889
NPI assigned
Jul 1, 2009
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301094966 MI Primary

Addresses

Primary practice location

3990 John R
Anesthesia Education Offices 2901
Detroit, MI 48201

Mailing address

1431 Washington Blvd
Apt 2814
Detroit, MI 48226-1732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130806000432 MI Practitioner - Anesthesiology 3173765005 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301094966MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Lake Anesthesiology Consultants, PLC Anesthesiology CurrentSince Jan 21, 2017 Accepting new patients
Waterford Anesthesia, PLLC Anesthesiology CurrentSince Jan 1, 2016 Accepting new patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Jul 1, 2013 Accepting new patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Jul 1, 2015 Accepting new patients
Waterford Surgical Center, LLC Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

3990 John R St
Ofc 2901
Detroit, MI 48201
Phone (313) 745-7233

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

1546 Callis Rd
Lapeer, MI 48446
Phone (810) 667-4000

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

5220 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 886-5555

5220 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 461-2800

Organizations & group practices 5

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.

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1578791224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 WASHINGTON BLVD",
            "address_2": "APT 2814",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482261732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R",
            "address_2": "ANESTHESIA EDUCATION OFFICES 2901",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-7233",
            "fax_number": "313-993-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301094966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.