MARC K FREDERICK – Physician Assistant, NPI 1083189831

MARC K FREDERICK is a healthcare provider. based in Salt lake city, Utah. specializing in PHYSICIAN ASSISTANT. The NPI Number for MARC K FREDERICK is 1083189831

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
MARC K FREDERICK
NPI
1083189831
Phone
(517) 420-8771
Address
2216 S FOOTHILL DR APT 310G
Enumeration Date
8 October 2018
Last Update Date
8 October 2018

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
8012687111
Graduation Year
2019 (7 years ago)
PAC ID
9638504558
Group Practice PAC ID
4284548116
Professional Enrollment ID
I20221028001047
Address ID
UT841241300SA1200X3900300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

1,972 PHYSICIAN ASSISTANT in UT

Provider Addresses for MARC K FREDERICK

  • 2216 S FOOTHILL DR APT 310G

    SALT LAKE CITY, UT 841093998

    Phone: (517) 420-8771

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-02-21 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-21

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2022-10-28

PECOS data refreshed: 2026-06-15

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
I20221028001047IPhysician AssistantUTTBD

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
99285Emergency department visit with high level of medical decision making9592$0
99284Emergency department visit with moderate level of medical decision making6463$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only5349$0
99291Critical care, first 30-74 minutes1818$0
View full utilization report →

Insurance plans in this area (ZIP 84109)

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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: 4284548116View full group profile
NameSpecialtyState
Emergency MedicineAZ
Emergency MedicineUT
Emergency MedicineUT
Emergency MedicineNV
Emergency MedicineCA
Emergency MedicineTX
-UT
Nurse PractitionerUT
Emergency MedicineUT
Emergency MedicinePA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARC K FREDERICK?
MARC K FREDERICK — NPI 1083189831 — is the standard way to identify this listing.
Does CMS list MARC K FREDERICK as active?
Yes — MARC K FREDERICK is active in the NPI listing used on this page.
What healthcare role does MARC K FREDERICK hold?
Scheduling teams often label MARC K FREDERICK under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect MARC K FREDERICK on a map?
Expect Salt Lake City, Utah as a primary anchor for MARC K FREDERICK unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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