Benjamin Edward Pendergrass, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC-62-TA-905 Issued in AL

Practice address

600 Washington St NW
Huntsville, AL 35801-4751

Phone

(256) 533-6838

NPI assigned

Jun 10, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpendergrass@direct.eyecare-partners.com

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.

• Eyecare Associates, Inc.

  • Eyewear Supplier
  • Birmingham, AL
  • NPI 1710012877

  Optometrist

  Medicare reassignment Care Compare group NPD
• Eyecare Associates, Inc.

  dba Eyecare Associates -Montgomery 4320

  • Optometrist
  • Montgomery, AL
  • NPI 1871475038
  NPD
• Eyecare Associates, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Jasper, AL
  • NPI 1255490041
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1396030912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD",
            "address_2": "SUITE 201",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON ST NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014751",
            "telephone_number": "256-533-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "BENJAMIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SC-62-TA-905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138715",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carter Austin Pelham, MD
• Samantha Dianne Pelham, PHARMD
• Sarah Pencille
• Brandon K Pendegraft, DPT
• Ashley Pendergrass, PHARM.D.
• Elizabeth Thomas Pendergrass, CRNP
• Sarah Larraine Pendergrass, LMSW
• Abbey Pendley
• Baylee Driggers Pendley
• Heath Robert Penland, M.D.

• Optometrist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.