Melanie Rose Pendergrass, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101020345 Issued in MI

Practice address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Phone

(810) 606-5000

NPI assigned

May 2, 2013

Sex

Female

Sole proprietor

Yes

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 MI

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

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Flint Hospital, Flint, MI, CCN 230141

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• McLaren Flint

  • General Practice Physician
  • Flint, MI
  • NPI 1275807372

  Family Medicine

  Medicare reassignment Care Compare group NPD
• McLaren Flint

  • Social Worker
  • Flint, MI
  • NPI 1356480685
  NPD
• McLaren Flint

  • Physician Assistant
  • Flint, MI
  • NPI 1700919628
  NPD
• Genesys Practice Partners Inc

  • Physician Assistant
  • Grand Blanc, MI
  • NPI 1114060837
  NPD (past)
• McLaren Flint

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1154469229
  NPD (past)
• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  NPD (past)

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

• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  Care Compare affiliation

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1508201799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091429",
            "telephone_number": "810-715-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "MELANIE",
        "middle_name": "ROSE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101020345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Lynn Peck, PA-C
• Benjamin Kyle Peek, DO
• Tiffany S Peeler, MA, LLPC, NCC
• Tanya Marie Peet, MSW
• Angela Pena
• Tammy Pendleton
• Periodontal Specialists of Grand Blanc PC
• Dey Perkins
• Roman Permyakov, DO
• Eileen Joe'L Perrigo, PHYSICAL THERAPIST

• Family Medicine Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.