Jean Pendergast, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

738682-01 Issued in NY

Practice address

405 Locust Ave
Oakdale, NY 11769-1651

Phone

(631) 868-1254

Fax

(631) 567-1648

NPI assigned

Jul 15, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1003540923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691651",
            "telephone_number": "631-868-1254",
            "fax_number": "631-567-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691651",
            "telephone_number": "631-868-1254",
            "fax_number": "631-567-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "JEAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "738682-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jpendergast@familyres.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "405 Locust Ave",
            "city": "Oakdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117691651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Pace, PSY.D.
• Laurie Palladino, RN
• Stacey L Pamlanye, OTR/L
• Krista Lynn Peacock, LMSW
• Pegasus DME Inc
• Nancy L Petrucelli
• Tracy Anne Peymann, LCSW
• Robert Pisciotta, DC
• Adewale Plumptre, MD
• William A Pomerantz, DDS

• Psychiatric/Mental Health Registered Nurse in Oakdale, NY
• Providers in Oakdale, NY by specialty
• Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.