Anthony Fredericks MD LLC

Primary specialty

Hospice and Palliative Medicine (Emergency Medicine) PhysicianTaxonomy code 207PH0002X

Legal business name

ANTHONY FREDERICKS MD LLC

Practice address

4516 Joe Dan PL NE
Albuquerque, NM 87110-5043

Phone

(760) 707-8504

NPI assigned

Aug 1, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Fredericks, MDNPI 1114486107

Title

Owner

Phone

(760) 707-8504

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Charles Fredericks, MD

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Albuquerque, NM
  • NPI 1114486107
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1932083102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 JOE DAN PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105043",
            "telephone_number": "760-707-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 JOE DAN PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105043",
            "telephone_number": "760-707-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY FREDERICKS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "FREDERICKS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-707-8504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akhil Ansary, M.D.
• Carolyn J Ansell, CNM
• Anshin Japanese Acupuncture, LLC
• Ansumana Gebeh MD, PA
• Daphina Jody Antal, LISW
• Brian Anthony, LCSW, LICSW
• Bryn Anthony, R.D.
• Grace Katherine Anthony, PTA
• Paul A Anthony, MD
• Yolanda Anthony, SLP

• Hospice and Palliative Medicine (Emergency Medicine) Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Hospice and Palliative Medicine (Emergency Medicine) Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.