NPIMap

Individual provider Active NPI

Desiree M Trader-Kent, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1447524533
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP011906 Issued in PA
Practice address
7604 Central Ave
Friend Hall Suite 101
Philadelphia, PA 19111-2433
Phone
(215) 707-3133
Fax
(215) 728-4293
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP011906 PA Primary

Addresses

Primary practice location

7604 Central Ave
Friend Hall Suite 101
Philadelphia, PA 19111-2433

Mailing address

3509 N Broad St FL 4
Philadelphia, PA 19140-4105
Phone (215) 707-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130305000297 PA Practitioner - Nurse Practitioner 8921253592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians
Roxborough Medical of Andorra LLCGroup PAC ID 0941520670, 7 clinicians

Practice addresses (Care Compare)

3509 N Broad St
Philadelphia, PA 19140-4105
Phone (215) 707-8484

701 E Cathedral Rd
Suite 11
Philadelphia, PA 19128-2128
Phone (267) 766-6321

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Holy Redeemer Hospital and Medical Center Hospital, Meadowbrook, PA, CCN 390097

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Nov 1, 2023 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Trivalley Primary Care, PC CurrentSince Apr 1, 2020 Accepting new patients
Primary Homecare, LLC Past Accepting new patients

Locations

519 S 5th St
Ste 130
Perkasie, PA 18944
Phone (215) 257-8601

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3509 N Broad St
Fl 4
Philadelphia, PA 19140
Phone (215) 707-6144

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

7604 Central Ave
Ste 101
Philadelphia, PA 19111
Phone (215) 745-8989

777 Route 113
Ofc
Souderton, PA 18964
Phone (215) 723-3280

2701 Blair Mill Rd
Ste 20
Willow Grove, PA 19090
Phone 21556727070

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDCBA

Organizations & group practices 6

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 9

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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1447524533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-6144",
            "fax_number": "215-707-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 CENTRAL AVE",
            "address_2": "FRIEND HALL SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112433",
            "telephone_number": "215-707-3133",
            "fax_number": "215-728-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRADER-KENT",
        "first_name": "DESIREE",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.