Charles Fredericks, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A161492 Issued in CA

Practice address

2315 Stockton Blvd
Sacramento, CA 95817-2201

Phone

(916) 734-5638

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Rutgers New Jersey Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Joaquin Faculty Medical GroupGroup PAC ID 4082631395, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Joaquin General Hospital Hospital, French Camp, CA, CCN 050167

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

71.65

Improvement activities

40

Cost

57.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Trauma Surgery Physician
  • Sacramento, CA
  • NPI 1568455590
  NPD

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

• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1992870430
  Care Compare affiliation

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1952747628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 GRAPE ST",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-5638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1653 W Congress Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123833",
            "country_code": "US",
            "telephone_number": "312-942-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125-063161",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A161492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Carol Frazzini, MSW LCSW
• Fred Behavior Consulting LLC
• Fred R Samimi, MD, a Professional Corporation
• Milton C. Fredenburg, DPM
• Paige Herse Fredenburg
• Justin Fredericks
• Cynthia Louise Frederickson, AUD
• Matthew Ryan Frederickson, MD
• Willard Lee Frederickson, M.D.
• Christine Fredrickson, BCBA

• Surgery Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.