Michael Edwin Frederich, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2009-0731 Issued in NM

Practice address

4371 E Lohman Ave
Las Cruces, NM 88011-8255

Phone

(575) 532-8900

Fax

(575) 532-8910

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: m.frederich@rgmgl-nm.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Familycare Associates,PA

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1821161407
  NPD (past)
• Prohealth Partners, a Medical Group, Inc.

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1639126279
  NPD (past)
• Providence Trinitycare Hospice

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Torrance, CA
  • NPI 1366034423
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1730115627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118255",
            "telephone_number": "575-532-8900",
            "fax_number": "575-532-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118255",
            "telephone_number": "575-532-8900",
            "fax_number": "575-532-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICH",
        "first_name": "MICHAEL",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "22879",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G84864",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2009-0731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009924",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.frederich.1@1928.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "4371 E Lohman Ave",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880118255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Veronica Fraser, REIKI MASTER
• Austin Frazier, ATC
• Jerome Frazier, D.O.
• Joshua Andrew Frazier
• Elizabeth Frazzini
• Samantha Fredericks
• Judy Louise Fredrickson, OTRL
• Jill M Freemyer, CNP
• Ryan Ross Freemyer, M.D.
• Graciella Freitas

• Family Medicine Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.