Melissa Ellison Frederikse, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MA06949500 Issued in NJ

Practice address

225 Millburn Ave
Suite 210
Millburn, NJ 07041-1737

Phone

(973) 218-1511

Fax

(973) 218-1477

NPI assigned

Jul 8, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2012 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1710910294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MILLBURN AVE",
            "address_2": "SUITE 210",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411737",
            "telephone_number": "973-218-1511",
            "fax_number": "973-218-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MILLBURN AVE",
            "address_2": "SUITE 210",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411737",
            "telephone_number": "973-218-1511",
            "fax_number": "973-218-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSE",
        "first_name": "MELISSA",
        "middle_name": "ELLISON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA06949500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8148007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Fowler, PT
• Michael C. Fox, DC
• Kelly Bartlett Francini, LCSW
• Trina Frankel, M.D.
• Franklin Square Health New Jersey LLC
• Freeman Integrated Spine and Pain PC
• Freeman Integrated Spine and Pain PC
• Amy Ilyse Freeman, MD
• Nancy Freundlich, M.D.
• Richard Evan Freundlich, M.D.

• Psychiatry Physician in Millburn, NJ
• Providers in Millburn, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.