FREDY MASONGSONG – Family Nurse Practitioner, NPI 1972951200
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for FREDY MASONGSONG
32748 GROAT BLVD
BROWNSTOWN, MI 481738636
Phone: (734) 236-4425
Type: Mailing
12100 DIX TOLEDO RD
SOUTHGATE, MI 481953531
Phone: (734) 282-5502
Type: Location
PO BOX 746723
ATLANTA, GA 303746723
Phone: (312) 733-9730
Fax: (773) 866-8014
Type: Mailing
27155 CHERRY HILL RD
INKSTER, MI 481411204
Phone: (313) 749-1178
Type: Location
13667 EUREKA RD
SOUTHGATE, MI 481951332
Phone: (734) 530-6777
Fax: (734) 468-1156
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 12 Open Payments records for all available years, with a total value of $663.
Total Amount is formed as General ($663) + Research ($0) + Ownership ($0) = $663.
Last reported payment date: 2024-10-08 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($211).
Total Amount
$663
General + Research + Ownership
Payments
12
Total payment records
General Amount
$663
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $211 |
| GlaxoSmithKline, LLC. | $164 |
| ABBVIE INC. | $125 |
| Medline Industries LP | $86 |
| ConvaTec Inc. | $77 |
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: 2020-11-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201125001421 | I | Nurse Practitioner | MI | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 128 | 59 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 21 | 21 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 19 | 19 | $0 |
| G0008 | Administration of influenza virus vaccine | 15 | 15 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 13 | 13 | $0 |
Insurance plans in this area (ZIP 48173)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MI | |
| Nurse Practitioner | GA | |
| - | IL | |
| Family Practice | WA | |
| Clinical Social Worker | MI | |
| - | IL | |
| Family Practice | IL | |
| Family Practice | TN | |
| Internal Medicine | NC | |
| Nurse Practitioner | GA |
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