CRYSTAL HOPE FREDRICKSON (PA) – Medical Physician Assistant, NPI 1649329996

CRYSTAL HOPE FREDRICKSON (PA) is a healthcare provider. based in Edmond, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 1324 (OK). The NPI Number for CRYSTAL HOPE FREDRICKSON (PA) is 1649329996

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
CRYSTAL HOPE FREDRICKSON (PA)
NPI
1649329996
Phone
(405) 216-5444
Address
3863 S Boulevard Ste 200
Enumeration Date
9 January 2007
Last Update Date
29 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4058038020
Graduation Year
2003 (23 years ago)
PAC ID
9537158902
Group Practice PAC ID
1658798103
Professional Enrollment ID
I20040511000094
Address ID
OK731208381OK13301AVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

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

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: 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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040511000094IPhysician AssistantOKTBD

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
17003Destruction of precancer skin growth, 2-14 growths1,837351$0
99213Established patient office or other outpatient visit, 20-29 minutes1,067820$0
17000Destruction of precancer skin growth, 1 growth651508$0
11102Biopsy of related skin growth, first growth298245$0
17110Destruction of skin growth, 1-14 growths193168$0
View full utilization report →

Insurance plans in this area (ZIP 73013)

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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: 1658798103View full group profile
NameSpecialtyState
D E R M A T O L O G YOK
Physician AssistantOK
D E R M A T O L O G YTX
Physician AssistantOK
Physician AssistantOK

Reviews

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Frequently asked questions

Does CRYSTAL HOPE FREDRICKSON (PA) have a public NPI I can cite?
Public records show CRYSTAL HOPE FREDRICKSON (PA) under NPI 1649329996.
Is CRYSTAL HOPE FREDRICKSON (PA) currently accepting referrals based on NPI status?
Registry metadata lists CRYSTAL HOPE FREDRICKSON (PA) as active.
What type of care does CRYSTAL HOPE FREDRICKSON (PA) provide?
CRYSTAL HOPE FREDRICKSON (PA)'s profile centers on Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to CRYSTAL HOPE FREDRICKSON (PA)?
CRYSTAL HOPE FREDRICKSON (PA) is associated with Edmond, Oklahoma in the same public data insurers reference.
Can I export CRYSTAL HOPE FREDRICKSON (PA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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