MELISSA A FREDRICKSON (PA-C) – Physician Assistant, NPI 1619245875

MELISSA A FREDRICKSON (PA-C) is a healthcare provider. based in Atlanta, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9106223 (FL). The NPI Number for MELISSA A FREDRICKSON (PA-C) is 1619245875

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MELISSA A FREDRICKSON (PA-C)
NPI
1619245875
Phone
(904) 202-1032
Address
PO BOX 746638
Enumeration Date
2 December 2011
Last Update Date
25 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9049401441
Graduation Year
2011 (15 years ago)
PAC ID
2668649773
Group Practice PAC ID
0648177733
Professional Enrollment ID
I20120112000576
Address ID
FL320924545ST230XXDRXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:14State licenses:1Digital endpointsOther names

9,232 PHYSICIAN ASSISTANT in FL

Provider Addresses for MELISSA A FREDRICKSON (PA-C)

  • PO BOX 746638

    ATLANTA, GA 303746638

    Phone: (904) 202-1032

    Fax: (904) 376-4107

    Type: Mailing

  • 98 NOCATEE VILLAGE DR

    PONTE VEDRA, FL 320816152

    Phone: (904) 824-1020

    Fax: (904) 824-5333

    Type: Location

  • PO BOX 45443

    SALT LAKE CITY, UT 841450443

    Phone: (904) 202-1032

    Fax: (904) 376-4107

    Type: Mailing

  • 400 COLONNADE DR STE 160

    PONTE VEDRA, FL 320816236

    Phone: (904) 824-1020

    Fax: (904) 824-5333

    Type: Location

  • 230 VILLAGE COMMONS DR

    ST AUGUSTINE, FL 320924545

    Phone: (904) 940-1441

    Fax: (904) 390-7463

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $194.

Total Amount is formed as General ($194) + Research ($0) + Ownership ($0) = $194.

Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($58).

Total Amount

$194

General + Research + Ownership

Payments

11

Total payment records

General Amount

$194

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-05

Latest reported date

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: 2012-01-12

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
I20120112000576IPhysician AssistantFLTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes197180$0
99213Established patient office or other outpatient visit, 20-29 minutes186175$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit2727$0
81003Automated urinalysis test2624$0
87804Detection test by immunoassay with direct visual observation for influenza virus1817$0
View full utilization report →

Insurance plans in this area (ZIP 30374)

Loading plans...

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: 0648177733View full group profile
NameSpecialtyState
Family PracticeFL
H O S P I T A L I S TUT
-UT
Hospitalist, Internal MedicineVA
Internal MedicineGA
Family PracticeUT
Hospitalist, Internal MedicineFL
H O S P I T A L I S TUT
R H E U M A T O L O G YUT
Hospitalist, Internal MedicineFL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I use this page to confirm MELISSA A FREDRICKSON (PA-C)'s NPI?
Yes. MELISSA A FREDRICKSON (PA-C) is listed with NPI 1619245875 in the public NPI dataset.
Does the file indicate MELISSA A FREDRICKSON (PA-C) is practicing under active NPI?
Directory data currently reports MELISSA A FREDRICKSON (PA-C) as active.
What is MELISSA A FREDRICKSON (PA-C)'s primary classification?
Physician Assistant is the headline specialty for MELISSA A FREDRICKSON (PA-C) here. Clinical services aligned with this taxonomy classification.
Does MELISSA A FREDRICKSON (PA-C) list a practice location?
Patients near Atlanta, Georgia may find MELISSA A FREDRICKSON (PA-C) in results; validate coverage separately.
Why does MELISSA A FREDRICKSON (PA-C) have multiple addresses?
5 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

Similar Providers

MRS. LYNN R THIBODEAU (PA)

Physician Assistant
Old Saint Augustine Road, Bayard, Jacksonville, Duval County, Florida, 32258, United States
NPI: 1811992696

MR. BRANDON D WEST (PA)

Physician Assistant
1835 SAVOY DR
NPI: 1871598425

FREDA ELLEN WALL (PA-C)

Surgical Physician Assistant
2001, Peachtree Road Northeast, Brookwood Hills, Atlanta, Georgia, 30309, United States
NPI: 1063417608

MS. CARMELLE BEAUVAIS (PA-C)

Medical Physician Assistant
9100 S DADELAND BLVD STE 1500
NPI: 1750387254
Collier Road Northwest, A, Atlanta, Georgia, 30318, United States
NPI: 1104822592

CARRIE SUE KNIPE (PAC)

Physician Assistant
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
NPI: 1962408229

LEE A COULTER (P.A.-C)

Physician Assistant
875 JOHNSON FERRY RD NE
NPI: 1942207535

CYNTHIA S BRAND (PA-C)

Physician Assistant
1404 RIVER PL STE 401
NPI: 1447257191
PO BOX 746093
NPI: 1720086994