Individual provider Active NPI

Hudson Michael Frey, M.D.

  • Otolaryngology Physician
  • Jackson, MS
National Provider Identifier
1629504402
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
T3774 Issued in TX
Practice address
2500 N State St
Ummc- Otolaryngology Department
Jackson, MS 39216-4500
Phone
(601) 984-5160
Fax
(601) 984-5085
NPI assigned
May 11, 2017
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X T3774 TX
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X T3774 TX
Otolaryngology Physician 207Y00000X T3774 TX Primary

Addresses

Primary practice location

2500 N State St
Ummc- Otolaryngology Department
Jackson, MS 39216-4500

Mailing address

6420 Bee Caves Rd
Austin, TX 78746-5925
Phone (512) 401-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220719003220 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 8628340478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Mississippi School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buckingham Center for Facial Plastic Surgery PAGroup PAC ID 1557342458, 3 clinicians

Practice addresses (Care Compare)

6420 Bee Caves Rd
Unit 100
Austin, TX 78746-6047
Phone (512) 401-2500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T3774TXMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Buckingham Center for Facial Plastic Surgery PA Otolaryngology CurrentSince Jul 1, 2022 Accepting new patients
Austin Anesthesiology Group, PLLC PastSince Jul 10, 2022 Accepting new patients

Locations

6420 Bee Caves Rd
Unit 100
Austin, TX 78746
Phone (512) 401-2500

Organizations & group practices 2

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1629504402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 BEE CAVES RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465925",
            "telephone_number": "512-401-2500",
            "fax_number": "512-401-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "UMMC- OTOLARYNGOLOGY DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5160",
            "fax_number": "601-984-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "HUDSON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TX",
            "license": "T3774",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "T3774",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "T3774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.