Jacob Fredrickson, DPT in Antioch, CA - Medicare Physical Therapist Provider

Jacob Fredrickson, DPT is a medicare enrolled "Physical Therapist" provider in Antioch, California. His current practice location is 4501 Sand Creek Rd, Antioch, California. You can reach out to his office (for appointments etc.) via phone at (925) 813-6500.

Jacob Fredrickson is licensed to practice in California (license number PT295900) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033670104.

Contact Information

	Jacob Fredrickson, DPT
	4501 Sand Creek Rd, Antioch, CA 94531-8687
	(925) 813-6500
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jacob Fredrickson
Gender	Male
Speciality	Physical Therapist
Location	4501 Sand Creek Rd, Antioch, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033670104
Provider Enumeration Date: 03/29/2019
Last Update Date: 01/03/2022

Medicare PECOS Information:

PECOS PAC ID: 4284039017
Enrollment ID: I20210817003153

Medical Identifiers

Medical identifiers for Jacob Fredrickson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033670104	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT295900 (California)	Primary

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. Jacob Fredrickson allows following entities to bill medicare on his behalf.

Provider Name	Permanente Medical Group Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Jacob Fredrickson 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 Address	Practice Location Address
Jacob Fredrickson, DPT 4691 Briones Valley Rd, Brentwood, CA 94513-4917 Ph: (925) 470-6444	Jacob Fredrickson, DPT 4501 Sand Creek Rd, Antioch, CA 94531-8687 Ph: (925) 813-6500

Reviews and Comments

Physical Therapist in Antioch, CA

Mark Benjamin Taylor, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2213 Buchanan Rd, Suite 210, Antioch, CA 94509 Phone: 925-779-2592 Fax: 925-779-2521
Matthew Robert White, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3400 Delta Fair Blvd, Antioch, CA 94509 Phone: 925-779-5442
Thisbe Coleman, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1210 A St, Antioch, CA 94509 Phone: 925-757-8787
Jessica Conroy, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4808 Golden Bear Dr, Antioch, CA 94531 Phone: 925-354-2298
Mrs. Jodi Sue Kabat, M.P.T. Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 5161 Lone Tree Way, Antioch, CA 94531 Phone: 925-522-8000 Fax: 925-522-8008
Empowerme Physical Therapy, P.c. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3950 Lone Tree Way, Antioch, CA 94509 Phone: 844-502-7996

Jacob Fredrickson, DPT - Medicare Physical Therapist in Antioch, CA