Individual provider Active NPI

Douglas Ryan Fredona, MSN, FNP-BC, FNP-C

  • Primary Care Nurse Practitioner
  • Salinas, CA
National Provider Identifier
1871361543
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95026950 Issued in CA
Practice address
1212 S Main St
Salinas, CA 93901-2260
Phone
(831) 422-7777
NPI assigned
Dec 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95026950 CA
Primary Care Nurse Practitioner 363LP2300X 95026950 CA Primary

Addresses

Primary practice location

1212 S Main St
Salinas, CA 93901-2260

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 242-8394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20240108004189 CA Practitioner - Nurse Practitioner 9830540483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Practice addresses (Care Compare)

1212 S Main St
Salinas, CA 93901-2260
Phone (831) 422-7777

3130 Del Monte Blvd
Marina, CA 93933-3047
Phone (831) 883-3330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95026950CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors on Duty Medical Group, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

3130 Del Monte Blvd
Marina, CA 93933
Phone (831) 883-3330

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

1756 N Main St
Salinas, CA 93906
Phone (831) 443-8200

1212 S Main St
Salinas, CA 93901
Phone (831) 422-7777

Interoperability endpoints

  • Direct secure messaging: dfredona18875@direct.svmh.com

Organizations & group practices 1

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1871361543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-242-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S MAIN ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939012260",
            "telephone_number": "831-422-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDONA",
        "first_name": "DOUGLAS",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "MSN, FNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026950",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95026950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.