NANCY FREDERIC NP NPI 1063716769

NPI Information

  • NPI: 1063716769
  • Provider Name: NANCY FREDERIC, NP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 75 CRESTMONT RD
    WEST ORANGE, NJ
    ZIP 07052
  • Phone: (973) 325-0805

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NPI Details

Nancy Frederic, NP is a psychiatric/mental health nurse practitioner in West Orange, NJ. Nancy Frederic, NP NPI is 1063716769. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

75 CRESTMONT RD
WEST ORANGE, NJ
ZIP 07052-626
Phone: (973) 325-0805

The NPI 1063716769 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

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.

  • Telehealth originating site facility fee (HCPCS:Q3014)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional (HCPCS:99484)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes (HCPCS:99336)

The enumeration date for this NPI number is 1/10/2011 and was last updated on 1/27/2022.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse581305NEW YORKNo
2163W00000XRegistered Nurse26NR17113600NEW JERSEYNo
3363LA2100XNurse PractitionerAcute Care430774NEW YORKNo
4363LP0808XNurse PractitionerPsychiatric/Mental Health26NJ00512000NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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