GARY W. FREDERICKSEN OD
NPI 1629035225
Optometrist in Williamsburg, VA
About Gary W. Fredericksen Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GARY W. FREDERICKSEN OD (NPI 1629035225) is an individual optometrist in Williamsburg, Virginia, licensed in Virginia (0618000905) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (1981).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Gary W. Fredericksen Od 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.
Medicare Billing Reassignment
Medicare enrollment records show Gary Fredericksen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Williamsburg, VA 23185
- Reassigned Medicare billing, Virginia enrollment
- 1,097 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 23185 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
WILLIAMSBURG, VA 23185
WILLIAMSBURG, VA 23185
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 Gary Fredericksen's NPI number?
The NPI number for Gary Fredericksen is 1629035225. It was assigned to this individual provider in the NPPES registry on April 27, 2006.
Where is Gary Fredericksen located?
Gary Fredericksen practices at 120 Kings Way Suite 1300, Williamsburg, VA 23185. The listed phone number is (757) 345-3001.
What is Gary Fredericksen's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Gary Fredericksen enrolled in Medicare?
Yes. Gary Fredericksen 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 Gary Fredericksen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gary Fredericksen reassigns Medicare benefits to Riverside Physician Services Inc (Williamsburg, VA). 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 Gary Fredericksen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Gary Fredericksen accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Oscar Health Insurance and 6 other insurers list Gary Fredericksen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Gary Fredericksen was last updated on November 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Gary W. Fredericksen, OD · NPI 1629035225
Optometrist provider in Williamsburg, Virginia. Individual provider, active in the CMS NPPES registry since April 27, 2006.
## Identity
- **NPI:** 1629035225 (Entity type: Individual)
- **Enumerated:** April 27, 2006
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 0618000905 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 120 KINGS WAY, SUITE 1300, Williamsburg, VA 23185-2505
- **Phone:** (757) 345-3001 · **Fax:** (757) 345-3102
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Riverside Physician Services Inc (NPI 1629086087, Williamsburg, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New England College Of Optometry, class of 1981
## Record status
- **NPPES last updated:** November 27, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1629035225) · Data from the CMS NPPES public registry.