NPIMap

Individual provider Active NPI

Kiel R Fredekind, PA-C

  • Medical Physician Assistant
  • Spokane, WA
National Provider Identifier
1982254892
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61126675 Issued in WA
Practice address
601 W 5TH Ave Ste 400
Spokane, WA 99204-2715
Phone
(509) 344-2663
NPI assigned
Sep 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61126675 WA Primary

Addresses

Primary practice location

601 W 5TH Ave Ste 400
Spokane, WA 99204-2715

Mailing address

601 W 5TH Ave Ste 400
Spokane, WA 99204-2715
Phone (509) 344-2663

Other practice location 1

601 W 5th Ave Ste 500
Spokane, WA 99204-2756
Phone (509) 344-8672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611002299 WA Practitioner - Physician Assistant 0749680700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Orthopaedic Specialists PS 83 clinicians

Practice addresses (Care Compare)

12410 E Sinto Ave
Suite 101
Spokane Valley, WA 99216-2258
Phone (509) 789-2955

601 W 5TH Ave
Suite 400
Spokane, WA 99204-2715
Phone (509) 344-2663

Hospital & facility affiliations

  • Deaconess Medical Center Hospital, Spokane, WA, CCN 500044
  • Multicare Valley Hospital Hospital, Spokane Valley, WA, CCN 500119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 10, 2021 Accepting new patients
Northwest Orthopaedic Specialists, P.S. CurrentSince Jan 1, 2023 Accepting new patients
Multicare Health System CurrentSince Mar 10, 2021 Accepting new patients
Northwest Orthopaedic Specialists PS CurrentSince Jan 1, 2023 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

601 W 5th Ave
Ste 500
Spokane, WA 99204
Phone (509) 344-2663

9310 N Division St
Spokane, WA 99218
Phone (509) 789-2836

601 W 5th Ave
Ste 100
Spokane, WA 99204
Phone (509) 343-3907

601 W 5th Ave
Ste 400
Spokane, WA 99204
Phone (509) 344-2663

2710 E 57th Ave
Spokane, WA 99223
Phone (509) 252-2354

910 W 5th Ave
Ste 900
Spokane, WA 99204
Phone (509) 530-5838

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: kfredekind569245@direct.multicare.org
  • Direct secure messaging: kiel.fredekind.1@16598.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1982254892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 5th Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042756",
            "country_code": "US",
            "telephone_number": "509-344-8672",
            "fax_number": "509-747-7838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDEKIND",
        "first_name": "KIEL",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61126675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.