DR. LUKE RICHARD FREDERICK (MD) – Urology Physician, NPI 1043507866

DR. LUKE RICHARD FREDERICK (MD) is a healthcare provider. based in Rockford, Illinois. specializing in UROLOGY. They hold the professional credentials MD. They hold a License No. 036140866 (IL). The NPI Number for DR. LUKE RICHARD FREDERICK (MD) is 1043507866

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. LUKE RICHARD FREDERICK (MD)
NPI
1043507866
Phone
(815) 398-4057
Address
351 EXECUTIVE PKWY
Enumeration Date
30 June 2011
Last Update Date
21 June 2016

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8153984057
Graduation Year
2011 (15 years ago)
PAC ID
3779723788
Group Practice PAC ID
3971604380
Professional Enrollment ID
I20160624000456
Address ID
IL611075339RO351XXPKWY300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:14State licenses:2Digital endpointsOther names

543 UROLOGY in IL

Provider Addresses for DR. LUKE RICHARD FREDERICK (MD)

  • 351 EXECUTIVE PKWY

    ROCKFORD, IL 611075339

    Phone: (815) 398-4057

    Fax: (815) 398-0220

    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 71 Open Payments records for all available years, with a total value of $1,558.

Total Amount is formed as General ($1,558) + Research ($0) + Ownership ($0) = $1,558.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($312).

Total Amount

$1,558

General + Research + Ownership

Payments

71

Total payment records

General Amount

$1,558

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

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: 2016-06-24

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
I20160624000456IUrologyILTBD

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
81003Automated urinalysis test579379$0
99213Established patient office or other outpatient visit, 20-29 minutes470363$0
51798Ultrasound measurement of bladder capacity after voiding225176$0
36415Insertion of needle into vein for collection of blood sample198154$0
84153Psa (prostate specific antigen) measurement, total197153$0
View full utilization report →

Insurance plans in this area (ZIP 61107)

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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: 3971604380View full group profile
NameSpecialtyState
-IL
Nurse PractitionerIL
U R O L O G YIL
U R O L O G YIL
Nurse PractitionerIL
U R O L O G YWI
U R O L O G YIL
U R O L O G YIL
Nurse PractitionerIL
U R O L O G YIL

Reviews

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Frequently asked questions

How is DR. LUKE RICHARD FREDERICK (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. LUKE RICHARD FREDERICK (MD) with NPI 1043507866.
Is DR. LUKE RICHARD FREDERICK (MD) listed as active for patients and plans?
The listing shows DR. LUKE RICHARD FREDERICK (MD) as active in the NPI system.
What taxonomy line describes DR. LUKE RICHARD FREDERICK (MD)?
For research purposes, treat DR. LUKE RICHARD FREDERICK (MD) as Urology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. LUKE RICHARD FREDERICK (MD) on a map?
Expect Rockford, Illinois as a primary anchor for DR. LUKE RICHARD FREDERICK (MD) unless the record lists multiple sites.
Why does DR. LUKE RICHARD FREDERICK (MD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.