GLENN H FREDENBURG
NPI 1679152664
Nurse Practitioner - Family in Buffalo, NY

Q: What is Glenn Fredenburg's NPI number?

The NPI number for Glenn Fredenburg is 1679152664. It was assigned to this individual provider in the NPPES registry on April 6, 2021.

Q: What is Glenn Fredenburg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Glenn Fredenburg was last updated on April 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 06, 2021PECOS EnrolledAccepts Medicare Assignment

40 LA RIVIERE DR STE 201, BUFFALO, NY 14202(518) 335-5097 Get Directions Write a Review

NPPES record last updated: April 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 27, 2022, Jul 20, 2021, Apr 6, 2021 (3 updates tracked since 2021).

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About Glenn H Fredenburg NPPES

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

GLENN H FREDENBURG (NPI 1679152664) is an individual family provider in Buffalo, New York, licensed in Vermont (101.0134798) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, is affiliated with Champlain Valley Physicians Hospital Medical Ctr, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1679152664

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameGLENN H FREDENBURG

Location Address40 LA RIVIERE DR STE 201Buffalo, NY 14202-4344

Mailing Address9467 State Route 9Chazy, NY 12921-2043 · (518) 335-5097

Phone(518) 335-5097

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateApril 6, 2021

Last NPPES UpdateApril 27, 20223 updates tracked since enumeration

NPPES CertifiedApril 27, 2022

✔ NPI 1679152664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VT · 101.0134798

40 LA RIVIERE DR STE 201, Buffalo, NY 14202

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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

Glenn H Fredenburg 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 ID2668876871

PECOS Enrollment IDI20210810004077

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.

Areas of Expertise CMS Part B claims 4

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.

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.

68 services64 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.

57 services50 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

46 services46 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.

15 services15 patients

Hospital Affiliations CMS Care Compare

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

Champlain Valley Physicians Hospital Medical Ctr

Acute Care Hospitals · Plattsburgh, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330250

Location75 Beekman StreetPlattsburgh, NY 12901 · Clinton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14202 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Urinary catheter anchoring device, leg strap, each A4334

DME-Orthotic Devices · category DF000N

1 supplier12 claims12 services$4.74 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

1 supplier12 claims12 services$7.95 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

1 supplier12 claims24 services$6.38 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

1 supplier14 claims280 services$5.15 avg. paid by Medicare

Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432

DME-Orthotic Devices · category DF010N

1 supplier11 claims220 services$3.17 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers12 claims12 services$62.05 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. MICHAEL HENRY KUEKER MD

Family Medicine