Anne Martin Fredericks, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95029319 Issued in CA

Practice address

400 W Pueblo St
Santa Barbara, CA 93105-4353

Phone

(805) 682-7111

NPI assigned

Mar 4, 2024

Last updated

Mar 4, 2024By the provider in NPPES

Sex

Female

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cottage Clinical Associates

  dba Cottage Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1235790544
  Medicare reassignment NPD
• Cottage Medical Foundation

  dba Cottage Medical Group

  • Clinic/Center
  • Santa Barbara, CA
  • NPI 1770352130
  Medicare reassignment NPD

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1649037029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CANON DR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931052638",
            "telephone_number": "805-708-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054353",
            "telephone_number": "805-682-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "ANNE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95029319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederic C. Kass, MD, Inc
• Frederic V Hepp, DDS, a Professional Dental Corporation
• Frederick and Weber Dental Care (Santa Barbara Dental Care)
• Amanda Frederick
• Jamie Frederick
• Cynthia Fredericksen
• Alexis Taylor Freeborn
• Dorenda M Freedman, MFT
• Freedom 4 Youth
• Paul Stephen Zagala Freedom

• Pediatric Nurse Practitioner in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.