Ryan Anthony Frederiksen, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A108502 Issued in CA

Practice address

13280 Evening Creek Dr S
San Diego, CA 92128-4101

Phone

(805) 403-9924

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, MI, OH, HI, NV, LA, WA, KY8 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 8

Specialty

Diagnostic Radiology

Education

Northeastern Ohio University College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medford Radiological Group PCGroup PAC ID 2062303324, 91 clinicians

Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Swedish Health ServicesGroup PAC ID 3173433067, 156 clinicians

Evergreen Radia LLCGroup PAC ID 4587568076, 116 clinicians

Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Radia Oregon Radiology Medical Group LLCGroup PAC ID 2961852637, 122 clinicians

Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 49)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ryan.fredricksen.p1@direct.wcchc.nextgenshare.com
• Direct secure messaging: rfrederiksen81022@scrippshlth.medalliesdirect.net

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.

• Radia California Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1740982032

  HI

  Medicare reassignment Care Compare group NPD
• Evergreen Radia LLC

  • Diagnostic Radiology Physician
  • Kirkland, WA
  • NPI 1922095694

  HI

  Medicare reassignment Care Compare group NPD
• Radia Inc P S

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607

  HI

  Medicare reassignment Care Compare group NPD
• Radia Oregon Radiology Medical Group LLC

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1073385423

  HI

  Medicare reassignment Care Compare group NPD
• Radiology Associates PA

  • Diagnostic Radiology Physician
  • Little Rock, AR
  • NPI 1366438186

  WA

  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Body Imaging Physician
  • Everett, WA
  • NPI 1114356904
  Medicare reassignment Care Compare group NPD
• Medford Radiological Group, PC

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1407938111

  HI

  Medicare reassignment Care Compare group
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment Care Compare group
• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• Fullerton Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1861451858
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1922260033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13280 EVENING CREEK DR S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284101",
            "telephone_number": "805-403-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13280 EVENING CREEK DR S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284101",
            "telephone_number": "805-403-9924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282604",
            "country_code": "US",
            "telephone_number": "408-885-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236819",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3220 Discovery Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489108609",
            "country_code": "US",
            "telephone_number": "517-975-8930",
            "fax_number": "517-337-4985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 510",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236805",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "RYAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A108502",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301106997",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A108502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2425 Geary Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941153358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Michelle Frederick, BSN
• Zachary Taylor Frederick
• Justin Fredericks, DO
• Nicole Fredericks
• Melissa Frederickson, MS, CCC/SLP
• Fredric a. Seldin, PH.D., PC
• Danielle Austin Fredricks
• Natalie Jean Fredricks, MA, AMFT
• Daniel Aaron Fredrickson, DMD
• Jenne Fredrickson

• Diagnostic Radiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.