Individual provider Active NPI

Kersten Elizabeth Reider, CRNP

  • Primary Care Nurse Practitioner
  • Mount Penn, PA
National Provider Identifier
1164033916
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP022230 Issued in PA
Practice address
2234 Perkiomen Ave
Mount Penn, PA 19606-1830
Phone
(610) 370-2511
NPI assigned
Aug 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP022230 PA Primary

Addresses

Primary practice location

2234 Perkiomen Ave
Mount Penn, PA 19606-1830

Mailing address

71 Kaley CT
Mohrsville, PA 19541-9708
Phone (610) 781-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200914001454 PA Practitioner - Nurse Practitioner 4688092240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians
Img Nursing Home Care, P.C.Group PAC ID 8628491735, 11 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2234 Perkiomen Ave
Reading, PA 19606-1830
Phone (610) 370-2511

82 Tunnel Rd
Pottsville, PA 17901-3869
Phone (570) 622-5455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group, P.C. CurrentSince Oct 26, 2020 Accepting new patients
Integrated Medical Group P C CurrentSince Oct 26, 2020 Accepting new patients
Img Nursing Home Care, P.C. CurrentSince Oct 26, 2020 Accepting new patients
Integrated Medical Group Past Accepting new patients

Locations

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

2234 Perkiomen Ave
Reading, PA 19606
Phone (610) 370-2511

Interoperability endpoints

  • Direct secure messaging: kreider@imgpc.medentdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1164033916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 KALEY CT",
            "city": "MOHRSVILLE",
            "state": "PA",
            "postal_code": "195419708",
            "telephone_number": "610-781-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2234 PERKIOMEN AVE",
            "city": "MOUNT PENN",
            "state": "PA",
            "postal_code": "196061830",
            "telephone_number": "610-370-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDER",
        "first_name": "KERSTEN",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP022230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Penn, PA

Sources for this page

Verify at the official NPI Registry.