Mark A Fredrickson (NPI# 1578530242, PAC ID# 3476463985) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1578530242 |
| PAC ID by PECOS | 3476463985 |
| Professional Enrollment ID | I20100105000175 |
| Full Name | Mark A Fredrickson |
| Address |
1800 Heritage Blvd Midland TX 79707-9750 |
| Phone Number | 4325201665 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS |
| Graduation Year | 1988 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450133 | MIDLAND MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1800 Heritage Blvd, Midland, TX 79707-9750 | 4325201665 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% |
| Street Address |
1800 HERITAGE BLVD |
| City | MIDLAND |
| State | TX |
| Zip | 79707-9750 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Varsha R Gillala | Physical Medicine and Rehabilitation | 1800 Heritage Blvd, Midland, TX 79707-9750 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cheryl J Vallie | Nurse Practitioner | 3423 Caldera, Midland, TX 79707-1111 | |
| Fidel L Ogeda | Family Medicine | 4506 Briarwood Ave, Suite A, Midland, TX 79707-2642 | |
| Michael P Wolbert | Allergy/immunology | 5000 Briarwood Ave, Midland, TX 79707-2753 | |
| Jessica N Salas | Nurse Practitioner | Briarwood Clinic, LLC | 5000 Briarwood Ave, Suite 203, Midland, TX 79707-2753 |
| Manish Dimri | Internal Medicine | Manish Dimri Md Pa | 3407 Caldera Blvd, Midland, TX 79707-2825 |
| Romeo P Papica Ii | Family Medicine | 3413 Caldera Blvd, Midland, TX 79707-2825 | |
| Roy J Mathew | Psychiatry | 3425 Caldera Blvd, Midland, TX 79707-2825 | |
| Eric J Venegas | Obstetrics/gynecology | 5007 Portico Way, Midland, TX 79707-3102 | |
| Sriyuta Thota | Optometry | 4400 N Midland Dr, Suite 404, Midland, TX 79707-3388 | |
| Kacee R Dunavan | Nurse Practitioner | Nsmd Medical Pllc | 4400 N Midland Dr, Midland, TX 79707-3388 |
| Find all physicians in zip 79707 | |||
| City | MIDLAND |
| Zip Code | 79707 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | MIDLAND + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Mark A Fredrickson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.