Samantha Jo Prendergast, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

344571 Issued in NY

Practice address

1656 Champlin Ave Ste 406
Utica, NY 13502-4830

Phone

(315) 269-9443

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.28 of 100Reported as group

Quality

75.06

Promoting interoperability

100

Improvement activities

40

Cost

69.26

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: sprendergast11781@mvhealthsystem.direct-ci.com

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1124689963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 REDFIELD AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012708",
            "telephone_number": "315-269-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 CHAMPLIN AVE STE 406",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135024830",
            "telephone_number": "315-269-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Utica, NY
• Providers in Utica, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.