ROBERT WINSTON FREDERICK (NPI# 1285671065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285671065 |
| Entity Type | Individual |
| Full Name | ROBERT WINSTON FREDERICK |
| Credential | M.D. |
| Practice Address |
925 Chestnut St 5th Floor Philadelphia PA 19107-4216 |
| Mailing Address |
833 Chestnut St Suite 1402 Philadelphia PA 19107-4414 |
| Practice Telephone | 2673393500 |
| Practice Fax Number | 2155030580 |
| Mailing Telephone | 8003219999 |
| Mailing Fax Number | 2673393761 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
25MA06942500 | NJ | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
MD068498L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | AETNA | 2170578 | 01 |
| PA | IBC | 0819217000 | 01 |
| NJ | IBC | 0440582000 | 01 |
| NJ | AETNA | 2378262 | 01 |
| CIGNA | 2781249 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619204690 | Robert Ray Frederick | Physician Assistant | 3366 Nw Expressway Ste 730, Oklahoma City, OK 73112-4454 | 2009-11-11 |
| 1629130752 | Robert Lynn Frederick | Pharmacist | 1002 W 13th St, Atoka, OK 74525-3435 | 2006-12-14 |
| 1780658112 | Robert W Frederick | Urology | 703 E Marshall Ave Ste 5007, Longview, TX 75601 | 2006-02-14 |
| Street Address |
925 CHESTNUT ST 5TH FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417953647 | Paul Edward Sullivan | Podiatrist | 925 Chestnut St, Fifth Floor, Philadelphia, PA 19107-4216 | 2005-06-22 |
| 1548868102 | Mary Elizabeth Rodgers | Social Worker | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-10-15 |
| 1679108559 | Sarah Jane Miranda | Internal Medicine | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-03-11 |
| 1558993493 | Noam Shohat | Student in an Organized Health Care Education/Training Program | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2020-02-09 |
| 1871130625 | Scott Paul Sheridan | Physical Therapist | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-11-27 |
| 1063057784 | Stephanie Dipaolo | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-11-18 |
| 1639732464 | Alexander Duffy | Student in an Organized Health Care Education/Training Program | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-04-17 |
| 1851856165 | Haley Ann Klose | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2019-01-31 |
| 1609347855 | Kathryn Yingling | Nurse Practitioner | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2018-12-16 |
| 1154808285 | Linda H Roberts | Social Worker | 925 Chestnut St, Philadelphia, PA 19107-4216 | 2018-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790323517 | Einstein Practice Plan Inc | Orthopaedic Surgery | 5501 Old York Rd Bldg Fl4, Philadelphia, PA 19141-3018 | 2019-12-11 |
| 1780622639 | Michael James Mandarino Jr. | Orthopaedic Surgery | 2832 Belmont Ave, Philadelphia, PA 19131-1519 | 2006-06-03 |
| 1730140153 | Kevin Blake Freedman | Orthopaedic Surgery | 925 Chestnut St, Fl 5, Rothman Institute, Philadelphia, PA 19107-4216 | 2006-03-28 |
| 1306833132 | Temple University of The Commonwealth System of Higher Education | Orthopaedic Surgery | 7604 Central Ave, Philadelphia, PA 19111-2433 | 2005-10-06 |
| 1245713908 | Temple Faculty Practice Plan, Inc | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1366961237 | Holy Family University | Orthopaedic Surgery | 9801 Frankford Ave, Philadelphia, PA 19114-2009 | 2017-09-12 |
| 1669871026 | Theresa Julia Christina Pazionis | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2014-08-21 |
| 1790121507 | Daniel Lim | Orthopaedic Surgery | 3400 Spruce St, Philadelphia, PA 19104 | 2013-05-20 |
| 1669714671 | Jamie Lyn Engel | Orthopaedic Surgery | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2013-03-18 |
| 1164788832 | Julie Shaner | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2012-04-07 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.