NPIMap

Individual provider Active NPI

Brian Paul Fremaux, DO

  • Family Medicine Physician
  • Soldotna, AK
National Provider Identifier
1629538095
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
196997 Issued in AK
Practice address
230 E Marydale Ave
Soldotna, AK 99669-7648
Phone
(907) 262-3119
Fax
(907) 262-9290
NPI assigned
Mar 22, 2019
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 125074291 IL
Family Medicine Physician 207Q00000X 196997 AK Primary

Addresses

Primary practice location

230 E Marydale Ave
Soldotna, AK 99669-7648

Mailing address

230 E Marydale Ave
Soldotna, AK 99669-7648
Phone (907) 262-3119

Other practice location 1

3231 Euclid Ave Fl 5
Berwyn, IL 60402-4603
Phone (708) 783-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026002028 AK Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4688040033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

805 Frontage Rd
Kenai, AK 99611-9104
Phone (907) 283-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196997AKMDFamily Medicine Physician
125074291ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services of Alaska, Inc. CurrentSince Oct 10, 2022 Accepting new patients
Peninsula Community Health Services of Alaska, Inc. Family Medicine CurrentSince Oct 10, 2022 Accepting new patients

Locations

805 Frontage Rd
Kenai, AK 99611
Phone (907) 262-3119

230 E Marydale Ave
Soldotna, AK 99669
Phone (907) 262-3119

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1629538095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E MARYDALE AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697648",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E MARYDALE AVE",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697648",
            "telephone_number": "907-262-3119",
            "fax_number": "907-262-9290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 Euclid Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604024603",
            "country_code": "US",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREMAUX",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125074291",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "196997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.