Warren Josef Pendergast Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

31889 Issued in NC

Practice address

4700 Homewood CT Ste 201
Raleigh, NC 27609-5732

Phone

(919) 787-7125

Fax

(919) 781-9952

NPI assigned

Jun 21, 2005

Last updated

Aug 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Minnesota Medical School, 1986

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Warren J. Pendergast, M.D., PLLC

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1881438364
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1376549857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 HOMEWOOD CT STE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095732",
            "telephone_number": "919-787-7125",
            "fax_number": "919-781-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 HOMEWOOD CT STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095732",
            "telephone_number": "919-787-7125",
            "fax_number": "919-781-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "WARREN",
        "middle_name": "JOSEF",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2024-08-03",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "31889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Jessie Pena
• Biancamaria Penati, PHD
• Clara Penati, LCSWA
• Madeline Anne Pence, PHYSICIAN ASSISTANT
• Madison Pender, MD
• Megan Leigh Pendergraft, ATC
• Thomas Elliott Pendergrast, M.D.
• Ernest Pendleton
• Summer Marie Penix-Bagby
• Tiffany Penley, M.ED., CCC-SLP

• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.