Mr Mark Frederick, PT is a medicare enrolled "Physical Therapist" provider in Paola, Kansas. His current practice location is
908 N Pearl St, Paola, Kansas. You can reach out to his office (for appointments etc.) via phone at
(913) 294-4308.
Mr Mark Frederick is licensed to practice in Kansas (license number 11-03035) 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 1306234604.
Healthcare Provider's Profile
| Full Name | Mr Mark Frederick |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 908 N Pearl St, Paola, Kansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1306234604
- Provider Enumeration Date: 01/08/2015
- Last Update Date: 01/08/2015
Medicare PECOS Information:
- PECOS PAC ID: 1759756851
- Enrollment ID: I20230403001462
Medical Identifiers
Medical identifiers for Mr Mark Frederick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306234604 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 11-03035 (Kansas) | 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. Mr Mark Frederick allows following entities to bill medicare on his behalf.
| Provider Name | Empowerme Rehabilitation Missouri Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1205334521
PECOS PAC ID: 9234402470
Enrollment ID: O20180810001282 |
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| Provider Name | Empowerme Wellness Kansas City Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1124619697
PECOS PAC ID: 9830504836
Enrollment ID: O20210304001079 |
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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. Mr Mark Frederick 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 |
|---|
Mr Mark Frederick, PT
908 N Pearl St,
Paola, KS 66071-1140
Ph: (913) 294-4308 | Mr Mark Frederick, PT
908 N Pearl St,
Paola, KS 66071-1140
Ph: (913) 294-4308 |
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