Individual provider Active NPI

Margot C Prendergast, LICSW

  • Clinical Social Worker
  • Morrisville, VT
National Provider Identifier
1164663035
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0001275 Issued in VT
Practice address
65 Northgate Plaza
Suite 11
Morrisville, VT 05661-5900
Phone
(802) 888-8320
Fax
(802) 888-8136
NPI assigned
Mar 23, 2009
Last updated
Jun 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089-0001275 VT Primary

Addresses

Primary practice location

65 Northgate Plaza
Suite 11
Morrisville, VT 05661-5900

Mailing address

24 Story Rd
North Middlesex, VT 05682-9662
Phone (802) 272-6559

Other identifiers 1

IdentifierTypeStateIssuer
1016282MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20090429000259 VT Practitioner - Clinical Social Worker 1658429733 Practice locations: Montpelier, VT; Hyde Park, VT; Berlin, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Vermont College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

111 W Main St
Hyde Park, VT 05655-4421
Phone (802) 272-6559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lamoille Health Partners Inc. Past Accepting new patients
Lamoille Health Partners, Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1164663035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 STORY RD",
            "city": "NORTH MIDDLESEX",
            "state": "VT",
            "postal_code": "056829662",
            "telephone_number": "802-272-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 NORTHGATE PLAZA",
            "address_2": "SUITE 11",
            "city": "MORRISVILLE",
            "state": "VT",
            "postal_code": "056615900",
            "telephone_number": "802-888-8320",
            "fax_number": "802-888-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "MARGOT",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0001275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016282",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisville, VT

Sources for this page

Verify at the official NPI Registry.