Scott D. Pendergast, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

35-072687 Issued in OH

Practice address

24075 Commerce Park
Beachwood, OH 44122-5846

Phone

(216) 831-5700

Fax

(216) 831-1959

NPI assigned

Sep 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Ophthalmology

Education

Boston University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Associates of Cleveland, Inc.Group PAC ID 2769463785, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Retina Associates of Cleveland, Inc.

  • Retina Specialist (Ophthalmology) Physician
  • Beachwood, OH
  • NPI 1912991225
  Medicare reassignment Care Compare group NPD
• Ophthalmic Physicians, Inc

  • Ophthalmology Physician
  • Mentor, OH
  • NPI 1265523237
  NPD (past)
• Retina Associates of Cleveland

  • Physician Assistant
  • Cleveland, OH
  • NPI 1841697463
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Youngstown LLC

  • Clinical Medical Laboratory
  • Warren, OH
  • NPI 1538233309

  Hospital

  Care Compare affiliation
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Warren, OH
  • NPI 1629009964
  Care Compare affiliation

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1386638682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24075 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225846",
            "telephone_number": "216-831-5700",
            "fax_number": "216-831-1959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24075 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225846",
            "telephone_number": "216-831-5700",
            "fax_number": "216-831-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35-07-2687-P",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "35-072687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021869",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE NUMBER",
            "identifier": "35-07-2687-P",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Place, Inc
• Gabriele Pedicelli, M.D.
• Karen Peereboom, CNP
• Brittany Peleg
• Kathy Pender, LPCC CCDC
• Laura Nikole Erskine Penix, AGACNP
• Emily E Pensky, LISW
• Alyssa Perchinske, APRN-CNP
• Amanda Perdomo
• Mabel Linairis Peregrin Delgado

• Retina Specialist (Ophthalmology) Physician in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Retina Specialist (Ophthalmology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.