Glenn H Fredenburg, - Medicare Nurse Practitioner in Buffalo, NY

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Glenn H Fredenburg, is a medicare enrolled "Nurse Practitioner - Family" in Buffalo, New York. He graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Adirondack Medical Practice Llc and his current practice location is 40 La Riviere Dr Ste 201, Buffalo, New York. You can reach out to his office (for appointments etc.) via phone at (518) 335-5097.

Glenn H Fredenburg is licensed to practice in Vermont (license number 101.0134798) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1679152664.

Contact Information

Glenn H Fredenburg,
40 La Riviere Dr Ste 201,
Buffalo, NY 14202-4344
(518) 335-5097
Not Available

Map and Direction




Provider's Profile

Full NameGlenn H Fredenburg
GenderMale
SpecialityNurse Practitioner
Experience5 Years
Location40 La Riviere Dr Ste 201, Buffalo, New York
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Glenn H Fredenburg graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1679152664
  • Provider Enumeration Date: 04/06/2021
  • Last Update Date: 04/27/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2668876871
  • Enrollment ID: I20210810004077

Medical Identifiers

Medical identifiers for Glenn H Fredenburg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679152664NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 101.0134798 (Vermont)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Champlain Valley Physicians Hospital Medical CtrPlattsburgh, NYHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Adirondack Medical Practice Llc04463389416

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Glenn H Fredenburg allows following entities to bill medicare on his behalf.
Entity NameAdirondack Medical Practice Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518136001
PECOS PAC ID: 0446338941
Enrollment ID: O20080424000278
Entity NameAshraf Medical Group Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821387382
PECOS PAC ID: 1850560830
Enrollment ID: O20110809000012
Entity NameMobile Physician Services Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194132415
PECOS PAC ID: 8325360290
Enrollment ID: O20141203001681

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glenn H Fredenburg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Glenn H Fredenburg,
9467 State Route 9,
Chazy, NY 12921-2043

Ph: (518) 335-5097		Glenn H Fredenburg,
40 La Riviere Dr Ste 201,
Buffalo, NY 14202-4344

Ph: (518) 335-5097

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.