Individual provider Active NPI

Brent M Pendergast, DNP,CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Lauderdale, FL
National Provider Identifier
1619636883
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11030608 Issued in FL
Practice address
4725 N. Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone
(954) 771-8000
NPI assigned
Dec 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11030608 FL Primary
Certified Registered Nurse Anesthetist 367500000X D184978 IA

Addresses

Primary practice location

4725 N. Federal Hwy
Fort Lauderdale, FL 33308-4603

Mailing address

2006 Hogback Rd.
Suite 5a
Ann Arbor, MI 48105-9750
Phone (734) 263-2414

Other identifiers 1

IdentifierTypeStateIssuer
121156300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240215003048 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416391636 Reassigns benefits to 2 organizations
I20250715000183 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416391636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-3121

4725 N Fed Hwy
Ft. Lauderdale, FL 33308-4603
Phone (954) 771-8000

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 542-6000

4725 N Federal Hwy 201
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 565-5807

4725 N Federal Hwy 302
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 351-5931

4725 N Federal Hwy 401
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 772-2136

4725 N Federal Hwy 501
Holy Cross Medical Group
Fort Lauderdale, FL 33308-4603
Phone (954) 351-7770

4725 N Federal Hwy 504
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 414-9750

4725 N Federal Hwy Cancer Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-7700

4725 N Federal Hwy HCMG Multispecialty
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-6770

4725 N Federal Hwy Neuro Radiology
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5780

4725 N Federal Hwy Nuclear Medicine
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5748

4725 N Federal Hwy Nuclear Medicine
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4668
Phone (954) 492-5748

4725 N Federal Hwy Pathology Departmen
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5728

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
  • Mercyone Des Moines Medical Center Hospital, Des Moines, IA, CCN 160083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D184978IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc Current Accepting new patients
Cep America - Anesthesia PC CurrentSince Jul 19, 2025 Accepting new patients
Cep America - Anesthesia PC CurrentSince Jul 19, 2025 Accepting new patients
Cep America - Anesthesia PC Current Accepting new patients
Holy Cross Hospital, Inc CurrentSince Jun 1, 2024 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Jan 7, 2024 Accepting new patients
Holy Cross Hospital, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4725 N Federal Hwy
#G
Ft Lauderdale, FL 33308
Phone (954) 492-5748

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 7

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 8

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1619636883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 HOGBACK RD.",
            "address_2": "SUITE 5A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059750",
            "telephone_number": "734-263-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N. FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-771-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "BRENT",
        "middle_name": "M",
        "credential": "DNP,CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11030608",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D184978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121156300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.