KRISTEN ALICE DERDERIAN (CNP) – Primary Care Nurse Practitioner, NPI 1407417645
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,972 NURSE PRACTITIONER in MA
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Provider Addresses for KRISTEN ALICE DERDERIAN (CNP)
Industrial Park Road, Taunton, Bristol County, Massachusetts, United States
TAUNTON, MA 027807396
Phone: (617) 669-4745
Type: Mailing
12200 WEBER HILL RD STE 100
SAINT LOUIS, MO 631271599
Phone: (314) 698-2500
Fax: (508) 823-5689
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $426.
Total Amount is formed as General ($426) + Research ($0) + Ownership ($0) = $426.
Last reported payment date: 2024-09-19 • Largest payer in this snapshot: Lilly USA, LLC ($85).
Total Amount
$426
General + Research + Ownership
Payments
20
Total payment records
General Amount
$426
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $85 |
| PFIZER INC. | $82 |
| Novo Nordisk Inc | $61 |
| Novartis Pharmaceuticals Corporation | $57 |
| AstraZeneca Pharmaceuticals LP | $52 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-12-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191219000953 | I | Nurse Practitioner | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 201 | 165 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 66 | 64 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 64 | 64 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 35 | 35 | $0 |
| 85610 | Blood test, clotting time | 25 | 11 | $0 |
Insurance plans in this area (ZIP 02780)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MA | |
| Nurse Practitioner | NY | |
| Diagnostic Radiology | ME | |
| Physician Assistant | MA | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MA | |
| Diagnostic Radiology | OH | |
| P A T H O L O G Y | MA | |
| Family Practice, Osteopathic Manipulative Medicine | MA | |
| Diagnostic Radiology, Interventional Radiology | NY |
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