Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1134869696 Individual Practitioner Male Practitioner

Dr. Kyle Matthew Fredrickson , MD

Pediatrics • Lakeville, MN

Professional Overview & Biography Verified Profile Summary

Dr. Kyle Fredrickson, MD is a certified Pediatrics practicing in Lakeville, MN. With approximately 4 years of clinical experience since graduating from Medical College Of Wisconsin in 2022, Dr. Fredrickson delivers high-quality medical care to the local community at 18484 KACHINA CT.

Dr. Fredrickson does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

18484 Kachina Ct

Lakeville, MN 550444886

Telephone 9529938800
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Medical College Of Wisconsin

Graduation Year

2022

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Lakeville, MN

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs -8.3 yrs vs City Avg
City Avg: 12.3 Yrs
State Avg: 20.6 Yrs
Regional Practice Density
6 Specialists

Practicing in Lakeville, MN (1325 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fredrickson (4 Years) 4 Yrs
Lakeville Specialty Average (12.3 Years) 12.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-05-12
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MN 82141

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License NC 2025-02382

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Practice Locations

Medical Center Boulevard

Winston Salem, NC 271570001

Phone: 3367169252

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Kelly Wilkinson , MA, LPCC

Counselor - Professional

NPI 1043504145

Master of Arts, Licensed Professional Clinical Counselor

Dr. Daniel Hanson , MD

Family Medicine

NPI 1164874574

Doctor of Medicine (M.D.)

NPI 1184282220

Doctor of Optometry

Kelly Krueger , APRN, CNP

Nurse Practitioner - Pediatrics

NPI 1215212261

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Paul Frenette , MD

Family Medicine

NPI 1457702706

Doctor of Medicine (M.D.)

NPI 1588305635

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location May 12, 2026

Registered at 18484 KACHINA CT, LAKEVILLE, MN 550444886 (Tel: 9529938800)

📍
Updated Business Mailing Address May 12, 2026

Registered at 8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 554254516

📍
Updated Practice Location January 22, 2026

Registered at MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 271570001 (Tel: 3367169252)

📍
Updated Business Mailing Address January 22, 2026

Registered at 100 KIMEL FOREST DR, WINSTON SALEM, NC 271036074 (Tel: 3367162255)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2025

Pediatrics (License #2025-02382 in NC)

NPI Profile Active March 31, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location March 31, 2022

Registered at 1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 271570001 (Tel: 3367166410)

📍
Updated Business Mailing Address March 31, 2022

Registered at 1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 271570001 (Tel: 3367166410)

👤
Provider Name / Credentials Updated March 31, 2022

Recorded as KYLE FREDRICKSON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 31, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 31, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134869696
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 31, 2022
Last Update: May 12, 2026
Sole Proprietor: No

Mailing Address

8170 33rd Ave S # Ms 21110q

Bloomington, MN 554254516

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.