Gary W. Fredericksen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000905 Issued in VA

Practice address

120 Kings Way
Suite 1300
Williamsburg, VA 23185-2505

Phone

(757) 345-3001

Fax

(757) 345-3102

NPI assigned

Apr 27, 2006

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.91 of 100Reported as apm

Quality

92.86

Promoting interoperability

94.93

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gfredericksen11629@direct.rivhs.com

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.

• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment Care Compare group NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623
  NPD
• Riverside Physician Services Inc

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1013933977
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1629035225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 J CLYDE MORRIS BLVD",
            "address_2": "SUITE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 1300",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-345-3001",
            "fax_number": "757-345-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSEN",
        "first_name": "GARY",
        "middle_name": "W.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia B Frankel
• Jace Franko, MD
• Kelly Wallace Franzone, MA, LPC, NCC
• Franklin Lawrence Freda, M.D.
• Jordyn Frederick
• Freedom-Focused Counseling LLC
• Meghan Dana Freeman, LCSW
• Summer French, PA-C
• Gilbert J Frey Jr., DDS
• Edward Bedell Freyfogle Jr., MD

• Optometrist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.