CRYSTAL HOPE FREDRICKSON (PA) – Medical Physician Assistant, NPI 1649329996
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
Provider Addresses for CRYSTAL HOPE FREDRICKSON (PA)
3863 S Boulevard Ste 200
Edmond, OK 730135540
Phone: (405) 216-5444
Fax: (405) 216-5445
Type: Location
PO BOX 54333
OKLAHOMA CITY, OK 731541333
Phone: (405) 803-8020
Fax: (405) 437-2332
Type: Mailing
3863, South Boulevard Street, Edmond, Oklahoma County, Oklahoma, 73034, United States
EDMOND, OK 730135540
Phone: (405) 216-5444
Fax: (405) 216-5445
Type: Mailing
13301 N MERIDIAN AVE STE 201
OKLAHOMA CITY, OK 731208381
Phone: (405) 803-8020
Fax: (405) 437-2332
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 120 Open Payments records for all available years, with a total value of $2,520.
Total Amount is formed as General ($2,520) + Research ($0) + Ownership ($0) = $2,520.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($382).
Total Amount
$2,520
General + Research + Ownership
Payments
120
Total payment records
General Amount
$2,520
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2004-05-11
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 |
|---|---|---|---|---|
| I20040511000094 | I | Physician Assistant | OK | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,837 | 351 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 1,067 | 820 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 651 | 508 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 298 | 245 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 193 | 168 | $0 |
Insurance plans in this area (ZIP 73013)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | OK | |
| Physician Assistant | OK | |
| D E R M A T O L O G Y | TX | |
| Physician Assistant | OK | |
| Physician Assistant | OK |
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