Fredric E Noller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00314800 Issued in NJ

Practice address

107 Berlin Rd
Cherry Hill, NJ 08034-3526

Phone

(856) 429-1800

Fax

(856) 429-1081

NPI assigned

Jul 29, 2013

Sex

Male

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

Enrolled in TX, OK2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dallas Pulmonary & Critical Care PA

  dba Exceed Medical P.A.

  • Critical Care Medicine (Internal Medicine) Physician
  • Dallas, TX
  • NPI 1235402728

  OK

  Medicare reassignment Care Compare group

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

• Integris Baptist Medical Center Inc

  dba INTEGRIS Decisions Mental Health and Addiction Recovery Programs

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
  • NPI 1598837221
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1659443372
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Health Baptist Medical Center

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1831103654
  Care Compare affiliation
• Integris Baptist Medical Center Inc

  dba Integris Mental Health Center Acute

  • Psychiatric Hospital Unit
  • Spencer, OK
  • NPI 1881760759
  Care Compare affiliation

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1790127934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BERLIN RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343526",
            "telephone_number": "856-429-1800",
            "fax_number": "856-429-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BERLIN RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343526",
            "telephone_number": "856-429-1800",
            "fax_number": "856-429-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLER",
        "first_name": "FREDRIC",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00314800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365793",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NJ Care at Home Services, LLC (PA Care at Home Services)
• Anthony Ogbonnaya Njoku, M.ED, M. SC
• Paul Nocella
• Nada Noiem, PT
• Jennifer Nolan
• Stephen R Noone, D.P.M.
• Nordstrom Inc & Subsidiaries
• Lynne Marie Norris, PT
• Northland Hearing Centers, Inc (Ascent Audiology & Hearing)
• Norton and Associates, Inc (Norton Staffing & Recruiting)

• Physician Assistant in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.