MR. RYAN TIMOTHY FREDRICKS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1962057034

MR. RYAN TIMOTHY FREDRICKS (CRNA) is a healthcare provider. based in Gilroy, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 95135050 (CA). The NPI Number for MR. RYAN TIMOTHY FREDRICKS (CRNA) is 1962057034

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
MR. RYAN TIMOTHY FREDRICKS (CRNA)
NPI
1962057034
Phone
(408) 607-0263
Address
9170 JACARANDA WAY
Enumeration Date
6 August 2019
Last Update Date
8 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5108931600
Graduation Year
2021 (5 years ago)
PAC ID
2163894130
Group Practice PAC ID
8224292123
Professional Enrollment ID
I20230221002130
Address ID
CA946122070OA300XXPLAZ401

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:6State licenses:2Other namesUpdated within 12 months

2,456 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

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Provider Addresses for MR. RYAN TIMOTHY FREDRICKS (CRNA)

  • 9170, Jacaranda Way, Gilroy, Santa Clara County, California, 95020, United States

    GILROY, CA 950207417

    Phone: (408) 607-0263

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $65.

Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.

Last reported payment date: 2024-03-13 • Largest payer in this snapshot: Janssen Biotech, Inc. ($65).

Total Amount

$65

General + Research + Ownership

Payments

2

Total payment records

General Amount

$65

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Janssen Biotech, Inc.$65
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-02-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230221002130ICertified Registered Nurse Anesthetist (Crna)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 95020)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224292123View full group profile
NameSpecialtyState
-CT
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

What identifier follows MR. RYAN TIMOTHY FREDRICKS (CRNA) across health systems?
The NPI 1962057034 uniquely identifies MR. RYAN TIMOTHY FREDRICKS (CRNA) in U.S. healthcare data.
Quick check: is MR. RYAN TIMOTHY FREDRICKS (CRNA) active?
Public NPPES data shows MR. RYAN TIMOTHY FREDRICKS (CRNA) with an active NPI status right now.
What does the directory say MR. RYAN TIMOTHY FREDRICKS (CRNA) does?
Insurance directories may phrase it differently, but here MR. RYAN TIMOTHY FREDRICKS (CRNA) maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. RYAN TIMOTHY FREDRICKS (CRNA)?
MR. RYAN TIMOTHY FREDRICKS (CRNA) shows a connection to Gilroy, California in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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