Erik Tyler Fredlund, PA-C, LAT, ATC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

2602 Brookhaven VW NE
Brookhaven, GA 30319-3198

Phone

(404) 374-0116

NPI assigned

Jul 7, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

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.

• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  Medicare reassignment

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1811209893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 BROOKHAVEN VW NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193198",
            "telephone_number": "404-374-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 BROOKHAVEN VW NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193198",
            "telephone_number": "404-374-0116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Coleman Ave",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312070001",
            "country_code": "US",
            "telephone_number": "478-301-2135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDLUND",
        "first_name": "ERIK",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "PA-C, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Fortenberry, MD
• William Anthony Foster II, DPT
• Keely Rochandaley Foster, LPC
• Michael Brooks Foster, NP-C
• Heather Fowler, PT, DPT, ATC
• Kaleigh Morgan Freel, PT, DPT
• Kwame Owura Frimpong
• Kendall Ellen Gallman
• Sheryle Gillette Gallmeier, PHARMD
• Gamble Dentalsmart, PC

• Medical Physician Assistant in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.