Peter D Fredericks (NPI# 1003010919, PAC ID# 4183871882) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1003010919 |
| PAC ID by PECOS | 4183871882 |
| Professional Enrollment ID | I20131009002052 |
| Full Name | Peter D Fredericks |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Address |
1400 E Boulder St Colorado Springs CO 80909-5533 |
| Gender | M |
| Medical School | UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE |
| Graduation Year | 2007 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 9638208549 |
| Number of Group Practice Members | 1070 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060022 | UCH-MEMORIAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 1400 E Boulder St, Colorado Springs, CO 80909-5533 | POUDRE VALLEY MEDICAL GROUP LLC | |
| 175 S Union Blvd, Colorado Springs, CO 80910-3126 | POUDRE VALLEY MEDICAL GROUP LLC | |
| 8890 N Union Blvd, Colorado Springs, CO 80920-2701 | POUDRE VALLEY MEDICAL GROUP LLC |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Physicians | 1041 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Henry Monkowski | Infectious Disease | Poudre Valley Medical Group LLC | 1625 Foxtrail Dr, Suite 200, Loveland, CO 80538-9089 |
| Nataliia A Baker | Family Medicine | Poudre Valley Medical Group LLC | 1455 Main St, Suite 100, Windsor, CO 80550-5559 |
| Stephanie Pivik Mager | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1715 61st Ave, Greeley, CO 80634-7989 |
| Kerri Alicia Madden | Physician Assistant | Poudre Valley Medical Group LLC | 4404 Barranca Ln, Unit 101, Castle Rock, CO 80104-7432 |
| Alicia Vandersluis | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 6705 Rangewood Dr, Colorado Springs, CO 80918-7300 |
| Megan Leigh Kelly | Clinical Social Worker | Poudre Valley Medical Group LLC | 11820 Destination Dr, Broomfield, CO 80021-2518 |
| Mark Oscar Robinson | Family Medicine | Poudre Valley Medical Group LLC | 15854 Jackson Creek Pkwy, Unit 120, Monument, CO 80132-8663 |
| Kimberly Atiyeh | Otolaryngology | Poudre Valley Medical Group LLC | 16222 W Us Hwy 24 210, Uchmg Woodland Park Outreach, Woodland Park, CO 80863-8763 |
| Adam Lee Kilkenney | Family Medicine | Poudre Valley Medical Group LLC | 5265 N Academy Blvd, Suite 1800, Colorado Springs, CO 80918-4061 |
| Marlesa Renee Moore | Obstetrics/gynecology | Poudre Valley Medical Group LLC | 1015 E Pikes Peak Ave, Suite 100, Colorado Springs, CO 80903-5700 |
| Street Address |
1400 E BOULDER ST |
| City | COLORADO SPRINGS |
| State | CO |
| Zip | 80909-5533 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kirsten Harlow | Physician Assistant | Poudre Valley Medical Group LLC | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| Eric Wu | Emergency Medicine | Emergency Medical Specialists, P.C. | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| Dawn Zablocki | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Suite 2508, Colorado Springs, CO 80909-5533 |
| Tien T Thach | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Uchmg Hospital Medicine, Colorado Springs, CO 80909-5533 |
| Kristina Elizabeth Glover | Psychiatry | Poudre Valley Medical Group LLC | 1400 E Boulder St, Uchmg Hospital Medicine, Colorado Springs, CO 80909-5533 |
| Jason C Murphy | Emergency Medicine | Emergency Medical Specialists, P.C. | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| Russell Allen | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Suite 2508, Colorado Springs, CO 80909-5533 |
| Jennifer R Kollman | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Suite 2508, Colorado Springs, CO 80909-5533 |
| Melissa Cary-jacobs Schmoekel | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Suite 2508, Colorado Springs, CO 80909-5533 |
| Matthew L Kolz | Anesthesiology | Poudre Valley Medical Group LLC | 1400 E Boulder St, Suite 2508, Colorado Springs, CO 80909-5533 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen K Underwood | Psychologist, Clinical | 2815 N Chelton Rd, Colorado Springs, CO 80909-1009 | |
| Cathleen L Oneill | Clinical Social Worker | Dr Horgan and Associates LLC | 2719 N Union Boulevard, Colorado Springs, CO 80909-1145 |
| Catherine Noelle O Shea | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Elizabeth A Gramith | Certified Registered Nurse Anesthetist (crna) | Epix Anesthesia of Colorado Springs, LLC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Courtney Furcini Frerichs | Physician Assistant | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Michael James Baker | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Karin Barbara Cesario | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Bryan Kavanaugh | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Dalette A Carlson | Certified Registered Nurse Anesthetist (crna) | Epix Anesthesia of Colorado Springs, LLC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| William W Lunt | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Find all physicians in zip 80909 | |||
| City | COLORADO SPRINGS |
| Zip Code | 80909 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | COLORADO SPRINGS + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Peter D Fredericks.
| 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.