Phillip E Pendleton, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

14610 Issued in CA

Practice address

275 The Crossroads Blvd Ste a
Carmel, CA 93923

Phone

(831) 718-9701

Fax

(831) 886-1538

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Hospital of the Monterey PeninsulaGroup PAC ID 7214839125, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145
• Salinas Valley Health Medical Center Hospital, Salinas, CA, CCN 050334

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Community Hospital of the Monterey Peninsula

  • General Acute Care Hospital
  • Monterey, CA
  • NPI 1225285810
  Medicare reassignment Care Compare group NPD
• Community Hospital of the Monterey Peninsula

  • General Acute Care Hospital
  • Monterey, CA
  • NPI 1932197258
  NPD
• Iraklis C Livas MD PSC

  • Specialist
  • Lexington, KY
  • NPI 1477622355
  NPD (past)

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

• Community Hospital of the Monterey Peninsula

  • Psychiatric Hospital Unit
  • Monterey, CA
  • NPI 1679562169
  Care Compare affiliation
• Community Hospital of the Monterey Peninsula

  • General Acute Care Hospital
  • Monterey, CA
  • NPI 1932197258
  Care Compare affiliation
• Salinas Valley Memorial Healthcare System

  • Rural Health Clinic/Center
  • Gonzales, CA
  • NPI 1437549284

  Hospital

  Care Compare affiliation
• Salinas Valley Memorial Healthcare System

  • General Acute Care Hospital
  • Salinas, CA
  • NPI 1750384079
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1528058898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 RYAN CT",
            "address_2": "STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407866",
            "telephone_number": "831-718-9701",
            "fax_number": "831-886-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 THE CROSSROADS BLVD STE A",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "93923",
            "telephone_number": "831-718-9701",
            "fax_number": "831-886-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "PHILLIP",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000962A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "14610",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4984P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78017547",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200379310",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "CA200946",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jill Nuckton, M.P.T.
• John M Obert-Hong, MD
• Brita Ostrom, MFT
• Hiromi Ozawa, P.T.
• Samantha Hsiaochien Pang
• Peninsula Sport Physical Therapy
• Brenda Perez
• Stephen Joseph Peroutka, MD, PHD
• Gemma Peterson
• Lindsey Phipps, MFTT

• Nurse Practitioner in Carmel, CA
• Providers in Carmel, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.