NPIMap

Individual provider Active NPI

Desiree Tricarico, MSN FNP-C

  • Nurse Practitioner
  • Ewa Beach, HI
National Provider Identifier
1871069849
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-2688 Issued in HI
Practice address
91-6390 Kapolei Pkwy, Suite 200
Ewa Beach, HI 96706
Phone
(808) 691-8200
Fax
(808) 691-3955
NPI assigned
Oct 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN-2688 HI Primary

Addresses

Primary practice location

91-6390 Kapolei Pkwy, Suite 200
Ewa Beach, HI 96706

Mailing address

91-6390 Kapolei Pkwy, Suite 200
Ewa Beach, HI 96706
Phone (808) 691-8200

Other practice location 1

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200608002166 HI Practitioner - Nurse Practitioner 7416378021 Reassigns benefits to 2 organizations
I20240321000032 TX Practitioner - Nurse Practitioner 7416378021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Alaska Regional Health ConsortiumGroup PAC ID 1456265362, 373 clinicians

Practice addresses (Care Compare)

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

  • Southeast Alaska Regional Health Consortium Hospital, Sitka, AK, CCN 021314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-2688HIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Physician Enterprise LLC CurrentSince Jun 1, 2020 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Mar 1, 2024 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
The Queens Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Mar 1, 2024 Accepting new patients
The Queen'S Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Larry J Kaufman MD LLC Obstetrics & Gynecology PastSince Feb 1, 2007 Accepting new patients
Queens University Medical Group PastSince Jun 1, 2020 Accepting new patients
Galileo Medical Group, NM PC Past Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

91-6390 Kapolei Pkwy
Ste 200
Ewa Beach, HI 96706
Phone (612) 802-2986

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Interoperability endpoints

  • Direct secure messaging: desiree.tricarico@hawaiihie.medicity.net
  • Direct secure messaging: dtricariconp@direct-searhc.org

Organizations & group practices 10

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 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1871069849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY, SUITE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-691-8200",
            "fax_number": "808-691-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-6390 KAPOLEI PKWY, SUITE 200",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "96706",
            "telephone_number": "808-691-8200",
            "fax_number": "808-691-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRICARICO",
        "first_name": "DESIREE",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "APRN-2688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewa Beach, HI

Sources for this page

Verify at the official NPI Registry.