DR. JON RANDALL FREDERICK (M.D.) – Emergency Medicine Physician, NPI 1003997800
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
130 GENERAL PRACTICE in VA
Provider Addresses for DR. JON RANDALL FREDERICK (M.D.)
8260 Atlee Rd
Emergency Dept
Mechanicsville, VA 23116
Phone: (804) 764-6300
Fax: (804) 764-6562
Type: Location
8260, Atlee Road, Mayfield Farms, Mechanicsville, Hanover County, Virginia, 23111, United States
EMERGENCY DEPT
MECHANICSVILLE, VA 23116
Phone: (804) 764-6300
Fax: (804) 764-6562
Type: Location
8639 MAYLAND DR STE 102
RICHMOND, VA 232944752
Phone: (804) 993-3039
Fax: (804) 447-1953
Type: Location
Corporate Boulevard, Lafayette, Lafayette Parish, Louisiana, 70502, United States
LAFAYETTE, LA 705083870
Phone: (800) 893-9698
Type: Mailing
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: 2021-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (987 days ago).
Enrollment records
2
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| I20140918000700 | I | Emergency Medicine | VA | 2023-09-30 |
| I20211027001137 | I | Emergency Medicine | DC | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 |
|---|---|---|---|---|
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 348 | 20 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 99 | 20 | $0 |
Insurance plans in this area (ZIP 23116)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Nurse Midwife (Cnm) | VA | |
| Clinical Social Worker | VA |
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