Jason Robert Fredriksen, | |
200 1st St Sw, Rochester, MN 55905-0001 | |
(507) 284-2511 | |
Not Available |
Full Name | Jason Robert Fredriksen |
---|---|
Gender | Male |
Speciality | Diagnostic Radiology |
Experience | 13 Years |
Location | 200 1st St Sw, Rochester, Minnesota |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477843720 | NPI | - | NPPES |
ENROLLED | Medicaid | MN | |
ENROLLED | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 106305 (Minnesota) | Secondary |
2085R0202X | Radiology - Diagnostic Radiology | 55612 (Minnesota) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Kingman Regional Medical Center | Kingman, AZ | Hospital |
Yuma Regional Medical Center | Yuma, AZ | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Yuma Regional Medical Center | 2062314826 | 284 |
Kingman Healthcare Inc | 6901791367 | 170 |
Entity Name | Yuma Regional Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194706655 PECOS PAC ID: 2062314826 Enrollment ID: O20040122000526 |
Entity Name | Kingman Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265423917 PECOS PAC ID: 6901791367 Enrollment ID: O20040216001173 |
Mailing Address | Practice Location Address |
---|---|
Jason Robert Fredriksen, 200 1st St Sw, Rochester, MN 55905-0001 Ph: (507) 284-2511 | Jason Robert Fredriksen, 200 1st St Sw, Rochester, MN 55905-0001 Ph: (507) 284-2511 |
Michael Bold, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 | |
Allison E Garda, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 | |
Tanner Henrie, Radiology Medicare: Medicare Enrolled Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 | |
Michael Leigh Wells, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 | |
Philippe Couillard, Radiology Medicare: Not Enrolled in Medicare Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 | |
Scott Christopher Lester, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: Mayo Clinic, 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 Fax: 507-284-0702 | |
Motassem Billah Nashawaty, MD Radiology Medicare: Medicare Enrolled Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 |