Alyssa Irene Fredbo, PA-C in Salt Lake City, UT - Medicare Physician Assistant

Alyssa Irene Fredbo, PA-C is a medicare enrolled "Physician Assistant" physician in Salt Lake City, Utah. Her current practice location is 50 N Medical Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (651) 323-8334.

Alyssa Irene Fredbo is licensed to practice in Utah (license number 13455633-1206) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1376226936.

Contact Information

	Alyssa Irene Fredbo, PA-C
	50 N Medical Dr, Salt Lake City, UT 84132-0001
	(651) 323-8334
	Not Available

Physician's Profile

Full Name	Alyssa Irene Fredbo
Gender	Female
Speciality	Physician Assistant
Location	50 N Medical Dr, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376226936
Provider Enumeration Date: 08/10/2023
Last Update Date: 03/04/2024

Medicare PECOS Information:

PECOS PAC ID: 6204286446
Enrollment ID: I20231229001384

Medical Identifiers

Medical identifiers for Alyssa Irene Fredbo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376226936	NPI	-	NPPES
2018031454	Other	UT	EMT

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RC0200X	Internal Medicine - Critical Care Medicine	13455633-1206 (Utah)	Secondary
363A00000X	Physician Assistant	13455633-1206 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alyssa Irene Fredbo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Alyssa Irene Fredbo, PA-C 2100 Park Ave Unit 682858, Park City, UT 84068-4615 Ph: () -	Alyssa Irene Fredbo, PA-C 50 N Medical Dr, Salt Lake City, UT 84132-0001 Ph: (651) 323-8334

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Alyssa Irene Fredbo, PA-C - Medicare Physician Assistant in Salt Lake City, UT