Jason-Anthony Kirkham Prendergast

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

License

17769 Issued in FL

Practice address

1451 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1961

Phone

(888) 773-3439

NPI assigned

Mar 16, 2018

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment Care Compare group NPD
• Edify Counseling Group LLC

  • Professional Counselor
  • Fort Lauderdale, FL
  • NPI 1922507730

  Pastoral

  NPD Authorized official

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1699278523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 NW 48TH AVE",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333194716",
            "telephone_number": "954-383-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 W CYPRESS CREEK RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091961",
            "telephone_number": "888-773-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "JASON-ANTHONY",
        "middle_name": "KIRKHAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "17769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premiermd Sim, LLC
• Premiermd Telemedicine, LLC
• Premiermd Vip Healthcare LLC
• Premium Standard Home Health of Florida Inc
• Conor Prendergast, MD
• Shanik D Prendes
• Prescriptrx Pharmacy LLC
• Prescriptrx Pharmacy LLC
• Paul George Preste, M.D.
• Prestige Cardiology Associates LLC

• Pastoral Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Pastoral Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.