Amy Fredericks, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

642293 Issued in NY

Practice address

3819 215TH PL
Bayside, NY 11361-2311

Phone

(646) 315-1505

NPI assigned

Apr 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1821432949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 215TH PL",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612311",
            "telephone_number": "646-315-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 215TH PL",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612311",
            "telephone_number": "646-315-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "AMY",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "642293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Form Physical Therapy Lifestyle Wellness PLLC
• Francis Lewis Medical, P.C.
• Frank Pappas DDS PC
• Michelle Frankino
• Rowen Kirron Frederick, FNP
• Freekneepain Inc.
• French Optical Fashion II, Inc.
• Fresh Meadows Medical Care PLLC
• Elyse Friedlin
• Elena M Friedman, D.M.D.

• Registered Nurse in Bayside, NY
• Providers in Bayside, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.