FREDERICK S DITMARS
NPI 1053012054
Student in an Organized Health Care Education/Training Program in Philadelphia, PA
About Frederick S Ditmars NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FREDERICK S DITMARS (NPI 1053012054) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT231623) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Frederick S Ditmars is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
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 Frederick Ditmars's NPI number?
The NPI number for Frederick Ditmars is 1053012054. It was assigned to this individual provider in the NPPES registry on March 15, 2023.
Where is Frederick Ditmars located?
Frederick Ditmars practices at 3400 Spruce St, Philadelphia, PA 19104. The listed phone number is (512) 923-4206.
What is Frederick Ditmars's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Frederick Ditmars enrolled in Medicare?
Yes. Frederick Ditmars is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Frederick Ditmars was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.
# Frederick S Ditmars · NPI 1053012054
Student in an Organized Health Care Education/Training Program provider in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since March 15, 2023.
## Identity
- **NPI:** 1053012054 (Entity type: Individual)
- **Enumerated:** March 15, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** MT231623 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3400 SPRUCE ST, Philadelphia, PA 19104-4238
- **Phone:** (512) 923-4206
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 2, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1053012054) · Data from the CMS NPPES public registry.