Wendy L Freden, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02370 Issued in TX

Practice address

5414 S Broadway Ave
Tyler, TX 75703-1335

Phone

(903) 581-1601

NPI assigned

May 30, 2008

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 17

Other names 1

• Wendy L Little Other name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: wfreden@dermatologyassociates.emadirect.md

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Medicare reassignment NPD
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Medicare reassignment
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)
• East Texas Medical Center Healthcare Associates

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1699719872
  NPD (past)
• Franklin, Favata & Hulls, MD'S, PA

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1841240439
  NPD (past)

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1750549358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841656",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841656",
            "telephone_number": "903-531-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031335",
            "telephone_number": "903-581-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDEN",
        "first_name": "WENDY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-048",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-1976930-005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8067NF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8068NF",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-028",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750549358",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201427604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-044",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8070NF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201427603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201427605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8069NF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201427606",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-015",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-022",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "LITTLE",
            "middle_name": "L",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Crystal L. Frazier I, PSY.D., M.P.A.
• Holli Lorainne Frazier, LVN
• Joan Marie Frazier, M.D.
• Molly Frazier
• Fred Kersh DO PA
• Bailey Fredenburg
• Fredrick J. Platt, DDS, PLLC
• Sheldon Ygnacio Freeberg, M.D.
• Cassandra Fay Freeland, MSN, APRN, FNP-BC
• Fraquania Talesh Freeman, APRN

• Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.