PATRICE R FREDERICK (MD) – Surgery Physician, NPI 1225288921
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PATRICE R FREDERICK (MD)
South Wood Street, Mount Pleasant, McKinley Park, Chicago, Cook County, Illinois, 60609, United States
CHICAGO, IL 606124325
Phone: (312) 355-1493
Type: Location
840 S Wood St Ste 435E
Chicago, IL 606124325
Phone: (312) 355-1493
Type: Location
1290 WATERMAN WAY STE 1290
TAVARES, FL 327785229
Phone: (352) 742-0054
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2022-11-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110114000772 | I | General Surgery | IL | TBD |
| I20221111000071 | I | General Surgery | FL | TBD |
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.
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 60612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| - | IL | |
| - | IL | |
| Gastroenterology, Internal Medicine | WI | |
| - | IL | |
| O P H T H A L M O L O G Y | NY | |
| O T O L A R Y N G O L O G Y | CA | |
| Certified Registered Nurse Anesthetist (Crna) | IA | |
| G A S T R O E N T E R O L O G Y | FL |
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