KRISTINE FREDERICK (NP) – Nurse Practitioner, NPI 1063503720

KRISTINE FREDERICK (NP) is a healthcare provider. based in Colorado springs, Colorado. specializing in Nurse Practitioner. They hold the professional credentials NP. They hold a License No. 108784 (CO). The NPI Number for KRISTINE FREDERICK (NP) is 1063503720

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
KRISTINE FREDERICK (NP)
NPI
1063503720
Phone
(719) 592-9890
Address
2685 DUBLIN BLVD
Enumeration Date
27 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7195929890
Graduation Year
1999 (27 years ago)
PAC ID
7214990423
Group Practice PAC ID
0941292635
Professional Enrollment ID
I20041109000544
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KRISTINE FREDERICK (NP)

  • 2685, Dublin Boulevard, Colorado Springs, El Paso County, Colorado, 80918, United States

    COLORADO SPRINGS, CO 809181358

    Phone: (719) 592-9890

    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 3 Open Payments records for all available years, with a total value of $254.

Total Amount is formed as General ($254) + Research ($0) + Ownership ($0) = $254.

Last reported payment date: 2023-07-20 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($186).

Total Amount

$254

General + Research + Ownership

Payments

3

Total payment records

General Amount

$254

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-20

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2004-11-09

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
I20041109000544INurse PractitionerCOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80918)

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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: 0941292635View full group profile
NameSpecialtyState
-CO

Reviews

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Frequently asked questions

Where can patients find KRISTINE FREDERICK (NP)'s NPI?
You can confirm KRISTINE FREDERICK (NP) with NPI 1063503720; it appears in the national provider directory.
Is KRISTINE FREDERICK (NP) currently active in the NPI registry?
CMS-published data lists KRISTINE FREDERICK (NP) as an active registrant.
What does KRISTINE FREDERICK (NP) treat or focus on?
Patients typically see KRISTINE FREDERICK (NP) under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does KRISTINE FREDERICK (NP) practice in Colorado?
You will see Colorado Springs, Colorado on file for KRISTINE FREDERICK (NP) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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