MRS. LYDIE-DANIELLE FREDERIC (PA-C) – Physician Assistant, NPI 1104160753
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
3,578 PHYSICIAN ASSISTANT in NJ
Provider Addresses for MRS. LYDIE-DANIELLE FREDERIC (PA-C)
130 Speedwell Ave
Morris Plains, NJ 079502315
Phone: (862) 242-8053
Type: Location
301 Riverview Ave Ste 202A
Norfolk, VA 235101065
Phone: (757) 252-9140
Fax: (757) 793-4149
Type: Location
130 SPEEDWELL AVE
MORRIS PLAINS, NJ 079502315
Phone: (862) 242-8053
Type: Location
750 BRUNSWICK AVE
TRENTON, NJ 086384143
Phone: (609) 394-6000
Type: Location
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: 2025-02-14
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 |
|---|---|---|---|---|
| I20150326000071 | I | Physician Assistant | NJ | TBD |
| I20250214000485 | I | Physician Assistant | VA | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 106 | 87 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 93 | 91 | $0 |
Insurance plans in this area (ZIP 07950)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | VA | |
| Nurse Practitioner | VA | |
| - | MI | |
| - | VA | |
| - | VA | |
| Pulmonary Disease, Internal Medicine | GA | |
| N E U R O L O G Y | VA | |
| Physician Assistant | VA | |
| - | VA | |
| Family Practice | VA |
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