DR. KIM S FREDERICKSON MD
NPI 1003995291
Dermatology in Novato, CA

Q: What is Kim Frederickson's NPI number?

The NPI number for Kim Frederickson is 1003995291. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Q: What is Kim Frederickson's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Kim Frederickson was last updated on October 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 06, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 05D0687240 · Certificate of Compliance

98.17/100

CMS Quality Rating

400 PROFESSIONAL CENTER DRIVE, SUITE 414 NOVATO DERMATOLOGY ASSOCIATES, NOVATO, CA 94947(415) 892-0754(415) 897-3204 Get Directions Write a Review

NPPES record last updated: October 10, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Kim S Frederickson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KIM S FREDERICKSON MD (NPI 1003995291) is an individual dermatology provider in Novato, California, licensed in California (G79619) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, holds a CLIA Certificate of Compliance certificate valid through March 21, 2027, and is a graduate of University Of California, Davis School Of Medicine (1993).

NPPES Registry Identity

NPI1003995291

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameDR. KIM S FREDERICKSONCredential: MD

Location Address400 PROFESSIONAL CENTER DRIVE, SUITE 414 NOVATO DERMATOLOGY ASSOCIATESNovato, CA 94947

Mailing Address400 Professional Center Drive, Suite 414Novato, CA 94947 · (415) 892-0754 · Fax (415) 897-3204

Phone(415) 892-0754

Fax(415) 897-3204

Sole ProprietorNo

Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 1993

Enumeration DateNovember 6, 2006

Last NPPES UpdateOctober 10, 2008

✔ NPI 1003995291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in CA · G79619

Definition

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.

400 PROFESSIONAL CENTER DRIVE, Novato, CA 94947

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Other Identifiers 3

Medicare UPING69391

Medicare ID-Type Unspecified00G796190

Medicare PIN00G796191CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kim S Frederickson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244205078

PECOS Enrollment IDI20040826000592

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kim Frederickson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novato Dermatology Associates A Medical Corporation

0.5 mi

Dermatology

867 DIABLO AVE
Novato, CA 94947

Reassigned Medicare billing, California enrollment
2 clinicians in this Medicare group

NPI 1003960063 (415) 892-0754

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0687240

Kim Frederickson MD · Novato, CA

Active · expires Mar 21, 2027

CLIA Number05D0687240

Laboratory TypePhysician Office

Certificate Effective DateMarch 22, 2025

Certificate Expiration DateMarch 21, 2027

Laboratory DirectorKim S. Frederickson MD

Laboratory Phone(415) 892-0754

Laboratory LocationKim Frederickson MD867 Diablo Ave, Novato, CA 94947

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

1,700 services290 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

644 services490 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

604 services378 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

577 services392 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

572 services417 patients

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

501 services247 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

233 services187 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm 12032

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

76 services61 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

73 services50 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

59 services59 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm 11602

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

58 services46 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

49 services44 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

45 services36 patients

Injection into skin growth, 1-7 growths 11900

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

41 services32 patients

Destruction of skin growth, 15 or more growths 17111

"Destruction of skin growth" refers to a procedure where unwanted skin growths, such as warts or moles, are removed. In this case, 15 or more growths are treated. Techniques may include freezing, burning, or laser therapy. It's a safe, quick process to improve skin health.

32 services30 patients

Simple or single drainage of skin abscess 10060

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

29 services23 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

27 services27 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

19 services19 patients

Biopsy of ear 69100

A biopsy of the ear is a medical procedure where a small sample of tissue is taken from your ear for examination. This helps doctors diagnose any abnormalities or diseases. It's a simple process, usually done under local anesthesia, and has minimal risks.

17 services15 patients

Tissue fungi or parasites 87220

Tissue fungi or parasites refer to microorganisms that can infect various parts of the body. This may cause symptoms like fatigue, fever, and skin changes. Diagnosis involves testing samples from the affected area. Treatment often includes medication to eliminate the infection.

15 services13 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm 11603

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

14 services13 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11642

This procedure involves the surgical removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 1.1-2.0 cm in size. This is done to prevent the cancer from spreading and to restore health.

14 services13 patients

Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm 11601

This procedure involves the surgical removal of a cancerous skin growth that measures between 0.6-1.0 cm, found on the body, arms, or legs. The goal is to eliminate cancer cells to prevent further spread. It's a common, safe, and effective treatment.

13 services11 patients

Removal of skin tag, 1-15 skin tags 11200

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

12 services12 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12052

This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.

12 services12 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11622

This procedure involves the careful removal of a cancerous skin growth measuring between 1.1 to 2.0 cm, located on the scalp, neck, hands, or feet. The goal is to eliminate the cancer and prevent its spread. This is done under local anesthesia to minimize discomfort.

11 services11 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm 12042

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94947 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.67 typical visit price

range $69.07 – $202.63

Typical copayment $26.16 (range $17.26 – $50.65)

Most-billed visit code 99203

Established Patient

$85.00 typical visit price

range $23.44 – $166.64

Typical copayment $21.25 (range $5.86 – $41.66)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.17/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

95.42

Improvement Activities

Cost

100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Frederickson's NPI number?

The NPI number for Kim Frederickson is 1003995291. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Where is Kim Frederickson located?

Kim Frederickson practices at 400 Professional Center Drive Suite 414 Novato Dermatology Associates, Novato, CA 94947. The listed phone number is (415) 892-0754.

What is Kim Frederickson's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Kim Frederickson enrolled in Medicare?

Yes. Kim Frederickson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kim Frederickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kim Frederickson reassigns Medicare benefits to Novato Dermatology Associates A Medical Corporation (Novato, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kim Frederickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Does Kim Frederickson hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0687240) is associated with this NPI, valid through March 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kim Frederickson was last updated on October 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.