Alyssa Irene Fredbo, PA-C is a medicare enrolled "Physician Assistant" physician in Salt Lake City, Utah. Her current practice location is
50 N Medical Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at
(651) 323-8334.
Alyssa Irene Fredbo is licensed to practice in Utah (license number 13455633-1206) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1376226936.
Physician's Profile
Full Name | Alyssa Irene Fredbo |
---|
Gender | Female |
---|
Speciality | Physician Assistant |
---|
Location | 50 N Medical Dr, Salt Lake City, Utah |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1376226936
- Provider Enumeration Date: 08/10/2023
- Last Update Date: 03/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 6204286446
- Enrollment ID: I20231229001384
Medical Identifiers
Medical identifiers for Alyssa Irene Fredbo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376226936 | NPI | - | NPPES |
2018031454 | Other | UT | EMT |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RC0200X | Internal Medicine - Critical Care Medicine | 13455633-1206 (Utah) | Secondary |
363A00000X | Physician Assistant | 13455633-1206 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alyssa Irene Fredbo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Alyssa Irene Fredbo, PA-C 2100 Park Ave Unit 682858, Park City, UT 84068-4615 Ph: () - | Alyssa Irene Fredbo, PA-C 50 N Medical Dr, Salt Lake City, UT 84132-0001 Ph: (651) 323-8334 |
Reviews and Comments