Dr Kim S Frederickson, MD is a medicare enrolled "Dermatology" physician in Novato, California. She went to University Of California, Davis School Of Medicine and graduated in 1993 and has 32 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Novato Dermatology Associates A Medical Corporation and her current practice location is
400 Professional Center Drive, Suite 414 Novato Dermatology Associates, Novato, California. You can reach out to her office (for appointments etc.) via phone at
(415) 892-0754.
Dr Kim S Frederickson is licensed to practice in California (license number G79619) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003995291.
Physician's Profile
| Full Name | Dr Kim S Frederickson |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 32 Years |
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| Location | 400 Professional Center Drive, Novato, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kim S Frederickson attended and graduated from University Of California, Davis School Of Medicine in 1993
NPI Data:
- NPI Number: 1003995291
- Provider Enumeration Date: 11/06/2006
- Last Update Date: 10/10/2008
Medicare PECOS Information:
- PECOS PAC ID: 0244205078
- Enrollment ID: I20040826000592
Medical Identifiers
Medical identifiers for Dr Kim S Frederickson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003995291 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | G79619 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Novato Dermatology Associates A Medical Corporation | 2466345467 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kim S Frederickson allows following entities to bill medicare on her behalf.
| Entity Name | Novato Dermatology Associates A Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003960063
PECOS PAC ID: 2466345467
Enrollment ID: O20040521000482 |
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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. Dr Kim S Frederickson 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 |
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Dr Kim S Frederickson, MD
400 Professional Center Drive, Suite 414,
Novato, CA 94947
Ph: (415) 892-0754 | Dr Kim S Frederickson, MD
400 Professional Center Drive, Suite 414 Novato Dermatology Associates,
Novato, CA 94947
Ph: (415) 892-0754 |
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