Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Lydie-Danielle Frederic, PA-C

Individual provider Physician Assistant · NPI 1104160753

Mrs. Lydie-Danielle Frederic, PA-C is a Physician Assistant in Trenton, New Jersey. Graduated from State University of New York Downstate Medical Center in 2012, 14 years ago. Practices with Sentara Medical Group, a 1,403-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New Jersey, New York and Virginia.

Years since qualifying
14
Trained at
State University of New York Downstate Medical Center
Licensed in
NJ, NY, VA
In the registry since
2012
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone: (609) 394-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 130 Speedwell Ave, Morris Plains, NJ 07950-2315 — (862) 242-8053
  • 301 Riverview Ave Ste 202a, Norfolk, VA 23510-1065 — (757) 252-9140

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110010195 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 016255 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00345300 (NJ)

Record details

NPI number1104160753
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 20, 2012
Last updated in NPPESJanuary 6, 2025
Certification dateJanuary 6, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSTATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduated 2012 (14 years in practice)
Group practice Sentara Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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