Jeff Andrew Prendergast, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

62888 Issued in CA

Practice address

160 E Virginia St
San Jose, CA 95112-5857

Phone

(408) 287-6200

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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.

• Gardner Family Health Network, Inc.

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1699841528

  CA

  Medicare reassignment Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • Gilroy, CA
  • NPI 1144358748
  Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • Alviso, CA
  • NPI 1164552931
  Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1407985534
  Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1558491043
  Care Compare group
• Gardner Family Health Network Inc

  • Clinic/Center
  • San Jose, CA
  • NPI 1699041566
  Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
  • NPI 1700915097
  Care Compare group
• Gardner Family Health Network Inc

  • Federally Qualified Health Center (FQHC)
  • Alviso, CA
  • NPI 1083654545
  NPD

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gardner Family Health Network Inc 24 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 6, 2023.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1063574804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125857",
            "telephone_number": "408-287-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125857",
            "telephone_number": "408-287-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "JEFF",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "62888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premiere Corporate Solutions
• Premierescan PC
• Premise Health of California Medical PC
• Premise Health of California Medical, P.C
• Premise Health of California Medical, P.C.
• Rachel Prentice, M.A
• Prescription Headquarters Inc
• Preserve Healthcare Services LLC
• Karen June Presley, SPEECH LANGUAGE PATH
• Whitney Brooke Pressley, MA

• All providers in San Jose, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.