LISA GAY FREDRICKSON FNP
NPI 1932533924
Nurse Practitioner - Family in Fort Bragg, CA
About Lisa Gay Fredrickson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LISA GAY FREDRICKSON FNP (NPI 1932533924) is an individual family provider in Fort Bragg, California, licensed in California (95026356) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lisa Gay Fredrickson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Lisa Fredrickson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Bragg, CA 95437
- Reassigned Medicare billing, California enrollment
- 33 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95437 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Lisa Fredrickson's NPI number?
The NPI number for Lisa Fredrickson is 1932533924. It was assigned to this individual provider in the NPPES registry on August 26, 2013.
Where is Lisa Fredrickson located?
Lisa Fredrickson practices at 205 South St, Fort Bragg, CA 95437. The listed phone number is (707) 961-1251.
What is Lisa Fredrickson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Lisa Fredrickson enrolled in Medicare?
Yes. Lisa Fredrickson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Lisa Fredrickson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Fredrickson reassigns Medicare benefits to Mendocino Coast Clinics Inc (Fort Bragg, 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 Lisa Fredrickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Lisa Fredrickson was last updated on November 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Lisa Gay Fredrickson, FNP · NPI 1932533924
Family physician in Fort Bragg, California. Individual provider, active in the CMS NPPES registry since August 26, 2013.
## Identity
- **NPI:** 1932533924 (Entity type: Individual)
- **Enumerated:** August 26, 2013
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95026356 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 205 SOUTH ST, Fort Bragg, CA 95437-5540
- **Phone:** (707) 961-1251
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mendocino Coast Clinics Inc (NPI 1083783757, Fort Bragg, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 18, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1932533924) · Data from the CMS NPPES public registry.