Individual provider Active NPI

Jennifer Lynn Fricke, FNP-C

  • Family Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1902371057
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005316 Issued in CA
Practice address
630 S Raymond Ave # Ut320
Pasadena, CA 91105-3278
Phone
(626) 795-4223
NPI assigned
Oct 4, 2018
Last updated
Oct 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005316 CA Primary

Addresses

Primary practice location

630 S Raymond Ave # Ut320
Pasadena, CA 91105-3278

Mailing address

532 Terrado Dr
Monrovia, CA 91016-3745
Phone (626) 353-6051

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
I20190521001556 CA Practitioner - Nurse Practitioner 4183967870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005316CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph J. Pachorek MD Inc a California Corporation CurrentSince Jan 5, 2019 Accepting new patients

Locations

630 S Raymond Ave
Unit 320
Pasadena, CA 91105
Phone (626) 795-4223

Interoperability endpoints

  • Direct secure messaging: jennifer.fricke.p42@direct.healthcarepartners.nextgenshare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1902371057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 TERRADO DR",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163745",
            "telephone_number": "626-353-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE # UT320",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053278",
            "telephone_number": "626-795-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.