Sean Joseph Prendergast

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD193346 Issued in OR

Practice address

525 N Santiam Hwy
Lebanon, OR 97355-4363

Phone

(541) 258-2101

Fax

(541) 451-7862

NPI assigned

May 11, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Merit-based Incentive Payment System (MIPS)

Final score

96.77 of 100Reported as group

Quality

88.09

Promoting interoperability

100

Improvement activities

40

Cost

84.48

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Mid-Valley Healthcare Inc

  • Critical Access Hospital
  • Lebanon, OR
  • NPI 1689625980
  Medicare reassignment NPD
• Mid-Valley Healthcare Inc

  • Addiction Medicine (Internal Medicine) Physician
  • Newport, OR
  • NPI 1740087899
  NPD

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1447606231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1193",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N SANTIAM HWY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-258-2101",
            "fax_number": "541-451-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "SEAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD193346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sprendergast165028@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "525 N Santiam Hwy",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Isaiah Pratt
• Victoria Jean Prawitz-Wiprud, DO
• Pregnancy Alternative Center
• Pregnancy Alternatives Center
• Premise Health of Oregon Medical P C
• Mandy R Prestenbach
• Charles Price, DO
• Garrett Price, PHARMD
• Rosita Rodriguez Proteau, PH.D., R.PH.
• PT Acquisitions LLC

• Emergency Medicine Physician in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.