Individual provider Active NPI

Amanda Friedrichs, MD

  • Dermatology Physician
  • Sycamore, IL
National Provider Identifier
1730281965
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036119759 Issued in IL
Practice address
1740 Mediterranean Dr Ste 102
Sycamore, IL 60178-3191
Phone
(815) 981-4990
Fax
(815) 517-0064
NPI assigned
Sep 1, 2006
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036119759 IL Primary

Addresses

Primary practice location

1740 Mediterranean Dr Ste 102
Sycamore, IL 60178-3191

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20081016000486 IL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 5193883320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

1740 Mediterranean Dr
Suite 102
Sycamore, IL 60178-3191
Phone (815) 981-4990

2051 Plainfield Rd
Crest Hill, IL 60403-1865
Phone (815) 741-4343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision79
Removal of skin lesions1448
Removal of skin cancer224
Removal or shaving of skin growth40
Skin biopsy410

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jun 21, 2022 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jun 21, 2022 Accepting new patients

Locations

2051 Plainfield Rd
Crest Hill, IL 60403
Phone (815) 730-9900

1740 Mediterranean Dr
Ste 102
Sycamore, IL 60178
Phone (815) 981-4990

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: amanda.friedrichs@forefrontdermatology.emadirect.md

Organizations & group practices 4

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1730281965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 MEDITERRANEAN DR STE 102",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783191",
            "telephone_number": "815-981-4990",
            "fax_number": "815-517-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICHS",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036119759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.