ALEX THOMAS FREDRICKSON MD
NPI 1417691056
Family Medicine in White Bear Lake, MN

Q: What is Alex Fredrickson's NPI number?

The NPI number for Alex Fredrickson is 1417691056. It was assigned to this individual provider in the NPPES registry on April 20, 2022.

Q: What is Alex Fredrickson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Alex Fredrickson was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since April 20, 2022PECOS EnrolledAccepts Medicare Assignment

1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110(651) 653-2100(651) 653-2125 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Alex Thomas Fredrickson Md NPPES

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

ALEX THOMAS FREDRICKSON MD (NPI 1417691056) is an individual family medicine provider in White Bear Lake, Minnesota, licensed in Minnesota (77098) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Regions Hospital, and is a graduate of University Of Minnesota Medical School (2022).

NPPES Registry Identity

NPI1417691056

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameALEX THOMAS FREDRICKSONCredential: MD

Location Address1430 HIGHWAY 96 EWhite Bear Lake, MN 55110-3653

Mailing Address8170 33rd Ave S # Ms 21110qBloomington, MN 55425-4516

Phone(651) 653-2100

Fax(651) 653-2125

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 2022

Enumeration DateApril 20, 2022

Last NPPES UpdateSeptember 23, 2025

NPPES CertifiedSeptember 23, 2025

✔ NPI 1417691056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 77098

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1430 HIGHWAY 96 E, White Bear Lake, MN 55110

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alex Thomas Fredrickson 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 ID4587043153

PECOS Enrollment IDI20251002000567

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Regions Hospital

Acute Care Hospitals · Saint Paul, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240106

Location640 Jackson StreetSaint Paul, MN 55101 · Ramsey County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55110 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

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

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.

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