DR. KIM S FREDERICKSON MD NPI 1003995291

NPI Details

DR. Kim S Frederickson, MD is a dermatology in Novato, CA with 33 years of experience. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. DR. Kim S Frederickson, MD NPI is 1003995291. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduation Year:1993

The provider's business location address is:

400 PROFESSIONAL CENTER DRIVE
SUITE 414 NOVATO DERMATOLOGY ASSOCIATES
NOVATO, CA
ZIP 94947
Phone: (415) 892-0754
Fax: (415) 897-3204

The NPI 1003995291 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0687240 - physician office with a certificate type of Certificate of Compliance.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
• Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
• Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
• Destruction of precancer skin growth, 1 growth (HCPCS:17000)
• Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
• Destruction of skin growth, 1-14 growths (HCPCS:17110)
• Biopsy of related skin growth, first growth (HCPCS:11102)
• Injection, triamcinolone acetonide, preservative free, 1 mg (HCPCS:J3300)
• Biopsy of related skin growth, each additional growth (HCPCS:11103)
• Simple or single drainage of skin abscess (HCPCS:10060)
• Destruction of skin growth, 15 or more growths (HCPCS:17111)
• Injection into skin growth, 1-7 growths (HCPCS:11900)
• Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
• Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
• New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
• Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
• Punch biopsy, first skin growth (HCPCS:11104)
• New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
• Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
• Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11642)
• Removal of skin tag, 1-15 skin tags (HCPCS:11200)
• Tissue fungi or parasites (HCPCS:87220)
• Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm (HCPCS:17261)
• Biopsy of ear (HCPCS:69100)
• Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm (HCPCS:12052)
• Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
• Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 11/6/2006 and was last updated on 10/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.