Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brett William Fredericksen, OD

Individual provider Optometrist · NPI 1194392845

Brett William Fredericksen, OD is an Optometry in Boise, Idaho. Graduated from University of Houston - College of Optometry in 2021, 5 years ago. Practices with Lwk P C, a 14-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Trained at
University of Houston - College of Optometry
Licensed in
ID
In the registry since
2021
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

291 N Milwaukee St Ste A-3
Boise, ID 83704-9132
Phone: (833) 776-2020
Fax: (208) 297-5718
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16448 N Midland Blvd, Nampa, ID 83687-5222 — (833) 776-2020

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence ODP-100533 (ID)

Record details

NPI number1194392845
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJune 9, 2021
Last updated in NPPESJune 9, 2021
Certification dateJune 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Graduated 2021 (5 years in practice)
Group practice Lwk P C — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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