Individual provider Active NPI

Denise A Salerno, MD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1639167539
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD056466L Issued in PA
Practice address
3223 N Broad St
Philadelphia, PA 19140-5007
Phone
(215) 707-5437
Fax
(215) 707-5180
NPI assigned
Oct 13, 2005
Last updated
May 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD056466L PA Primary

Addresses

Primary practice location

3223 N Broad St
Philadelphia, PA 19140-5007

Mailing address

2450 W Hunting Park Ave
3/208N
Philadelphia, PA 19129-1302
Phone (215) 707-5437

Other identifiers 1

IdentifierTypeStateIssuer
0015839900001MedicaidPA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161230000020 PA Practitioner - Pediatric Medicine 9739460916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD056466LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc CurrentSince Mar 9, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 9, 2019 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

2450 W Hunting Park Ave
#3208N
Philadelphia, PA 19129
Phone (215) 707-3911

3223 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2900

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

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1639167539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "address_2": "3/208N",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-5437",
            "fax_number": "215-707-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-5437",
            "fax_number": "215-707-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALERNO",
        "first_name": "DENISE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD056466L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015839900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.