John Randall Frederick, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M.D.032063E Issued in PA

Practice address

1650 Huntingdon Pike
Suite 154
Meadowbrook, PA 19046-8004

Phone

(215) 938-3145

Fax

(215) 938-3144

NPI assigned

Nov 10, 2005

Last updated

Jan 5, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Renew Wound Care of Pennsylvania LLC

  • Internal Medicine Physician
  • Wyncote, PA
  • NPI 1194442640
  Medicare reassignment NPD
• Vohra Post Acute Care Physicians of the Northeast PA

  • Family Medicine Physician
  • Bryn Mawr, PA
  • NPI 1275969131
  Medicare reassignment NPD
• HR Physician Services

  dba Redeemer Physical Therapy at Richboro

  • Rehabilitation Clinic/Center
  • Richboro, PA
  • NPI 1730650151
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1669453213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HUNTINGDON PIKE",
            "address_2": "SUITE 154",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468004",
            "telephone_number": "215-938-3145",
            "fax_number": "215-938-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HUNTINGDON PIKE",
            "address_2": "SUITE 154",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468004",
            "telephone_number": "215-938-3145",
            "fax_number": "215-938-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JOHN",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "M.D.032063E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1886916-03",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pantaleon L Fagel, MD
• Donna R Farrell, DO
• Joseph Saul Fisher, MD
• Kyle W. Fisher, M.D.
• James Leon Fox Jr.
• Fuller Family Health and Wellness, P.C.
• Simon Galapo, MD
• Dominick A Galluzzo, MD
• Ratna Ganabathi, D.O.
• Rita George, DO

• Surgery Physician in Meadowbrook, PA
• Providers in Meadowbrook, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.