Frederick Customeyez Prosthetics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

O.24 Issued in OH

Legal business name

FREDERICK CUSTOMEYEZ PROSTHETICS LLC

Practice address

1422 Euclid Ave
Suite 802
Cleveland, OH 44115-1902

Phone

(401) 584-3939

NPI assigned

Nov 26, 2016

Organization subpart

No

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

Authorized official

Name

Melissa Frederick

Title

Ocularist/Owner

Phone

(401) 584-3939

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Frederick Customeyez Prosthetics LLC

  • Ocularist
  • Saint Louis, MO
  • NPI 1841926599

  0042594244

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Frederick Customeyez Prosthetics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Frederick Customeyez in St. Louis

  • Clinic/Center
  • Saint Louis, MO
  • NPI 1912603507
  NPD tax ID
• Frederick Customeyez Prosthetics LLC

  • Ocularist
  • Saint Louis, MO
  • NPI 1841926599
  NPD tax ID

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

{
    "created_epoch": "1480118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751500800000",
    "number": "1912440843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9278 PARADISE DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324139625",
            "telephone_number": "401-584-3939",
            "fax_number": "216-678-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 EUCLID AVE",
            "address_2": "SUITE 802",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441151902",
            "telephone_number": "401-584-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK CUSTOMEYEZ PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-26",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OCULARIST/OWNER",
        "authorized_official_telephone_number": "401-584-3939"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "O.24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Frazier
• Shindana N Frazier, LPN
• Susan Marie Frazier
• Samantha Freck, MSN, APRN, NP-C
• Fred S Hirsh MD Inc
• Marguerite Sherwin Frederick, LISW
• Melissa Frederick
• Valerie Rene Fredericks
• Rachel Fredericksen
• Alice Erica Fredrickson, M.D.

• Prosthetic/Orthotic Supplier in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Prosthetic/Orthotic Supplier in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.