Active NPI
Anne M Frederickson, MD
- Child & Adolescent Psychiatry Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 434036
- Practice address
- 100 E Lehigh Ave
Philadelphia, PA 19125-1012 - Phone
- (215) 707-8496
- Fax
- (215) 707-4086
- NPI assigned
- Nov 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 25MA09605400 | NJ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 434036 | PA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MA09605400 | NJ |
Addresses
Primary practice location
100 E Lehigh Ave
Philadelphia, PA 19125-1012
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-8496
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Albert Einstein College of Medicine of Yeshiva University, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
201 Lyons Ave
Newark, NJ 07112-2027
Phone (732) 923-7455
Hospital & facility affiliations
- Newark Beth Israel Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.51 of 100
- Quality
- 84.27
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09605400 | NJ | MD | Neurology Physician |
| 434036 | PA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group, PC | Current | Accepting new patients | |
| Rwjbh Observation Associates LLC | Current | Accepting new patients | |
| Newark Beth Israel Medical Center Inc | Past | Accepting new patients | |
| Newark Beth Israel Medical Center Inc | Past | Accepting new patients |
Locations
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833
1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763
266 King George Rd
Warren, NJ 07059
Phone (732) 667-7778
223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838
Interoperability endpoints
- afrederickson43004@epicdirect.rwjbh.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.
-
- Specialist
- West Orange, NJ
- NPI 1447206420
-
- Emergency Medicine Physician
- Livingston, NJ
- NPI 1760095806
-
- Psychiatric Hospital Unit
- Newark, NJ
- NPI 1043457955
-
- General Acute Care Hospital
- Newark, NJ
- NPI 1215027966
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newark, NJ
- NPI 1215027966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1629259288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 W HUNTING PARK AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191291302",
"telephone_number": "215-707-8496",
"fax_number": "215-707-4086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LEHIGH AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191251012",
"telephone_number": "215-707-8496",
"fax_number": "215-707-4086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKSON",
"first_name": "ANNE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-23",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NJ",
"license": "25MA09605400",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "PA",
"license": "434036",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MA09605400",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.