Individual provider Active NPI

Edith Marie Prendergast, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1417436817
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343402 Issued in NY
Practice address
530 1St Ave Ste 10Q
New York, NY 10016
Phone
(212) 263-7021
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343402 NY Primary

Addresses

Primary practice location

530 1St Ave Ste 10Q
New York, NY 10016

Mailing address

530 1St Ave
New York, NY 10016-6402

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eprendergast31158@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180904001029 NY Practitioner - Nurse Practitioner 8820348386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

97 Amity St
Brooklyn, NY 11201-6004
Phone (212) 598-6784

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 1, 2018 Accepting new patients
New York University CurrentSince Sep 1, 2018 Accepting new patients

Locations

530 1st Ave
Ste 10Q
New York, NY 10016
Phone (212) 263-6358

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: eprendergast31158@nyumc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1417436817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE STE 10Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-263-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "EDITH",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eprendergast31158@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "530 1st Ave Ste 10Q",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "10016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.