Individual provider Active NPI

Wendy Douglas Frickel, MD

  • Family Medicine Physician
  • Ithaca, NY
National Provider Identifier
1760475966
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
161578 Issued in NY
Practice address
101 Dates Drive
Cayuga Medical Ctr
Ithaca, NY 14850
Phone
(607) 274-4322
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 161578 NY Primary

Addresses

Primary practice location

101 Dates Drive
Cayuga Medical Ctr
Ithaca, NY 14850

Mailing address

76 Delaware Ave
Damascus, PA 18415
Phone (570) 224-8899

Other identifiers 1

IdentifierTypeStateIssuer
02632162MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20070726000172 GU Practitioner - Family Practice 7012987688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Takecare Insurance Company IncGroup PAC ID 8325951239, 28 clinicians

Practice addresses (Care Compare)

548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5825

Hospital & facility affiliations

  • FHP Home Health Home health agency, Tamuning, GU, CCN 657005
  • FHP Home Health - Hospice Hospice, Tamuning, GU, CCN 651501

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161578NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Takecare Insurance Company Inc. Family Medicine CurrentSince Jan 16, 2018 Accepting new patients
Johns Hopkins Community Physicians, Inc Family Medicine Past Accepting new patients
New York Em-I Medical Services PC Past Accepting new patients

Locations

548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
FHP Home Health - HospiceTamuning, GU, CCN 651501 Hospice W-2 Managing Employee Oct 29, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1760475966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 DELAWARE AVE",
            "city": "DAMASCUS",
            "state": "PA",
            "postal_code": "18415",
            "telephone_number": "570-224-8899",
            "fax_number": "570-224-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DRIVE",
            "address_2": "CAYUGA MEDICAL CTR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-274-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKEL",
        "first_name": "WENDY",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "161578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.