Michael Patrick Prendergast, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1 Childrens PLZ
Dayton, OH 45404-1873

Phone

(937) 641-3433

NPI assigned

Apr 23, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mprendergast668352@hisp.ehr.sutterhealth.org
• Direct secure messaging: mprendergast128313@direct.chmca.org

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.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414

  Pediatrics

  Medicare reassignment NPD
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment NPD
• Akron Children's Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664064000000",
    "number": "1730743964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-3433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Machias",
            "state": "ME",
            "postal_code": "046543325",
            "country_code": "US",
            "telephone_number": "207-255-3356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-09-25",
        "certification_date": "2022-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD26386",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE BOARD OF MEDICINE",
            "identifier": "MD26386",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Integrated Medical Assoc LTD (PriMed Physicians)
• Premier Integrated Medical Assoc. LTD. (PriMed Physicians)
• Premier Integrated Medical Associates, LTD (Primed Laboratory)
• Premise Health of Ohio Medical PA
• Premium Home Healthcare Services, LLC
• Danielle Presley
• Kristin Pressley, CDCA
• Belinda Marie Preston-Cash, LICDC
• Daejanna Latriece Preston, LSW
• Hilary Nicole Preston, APRN

• Student in an Organized Health Care Education/Training Program in Dayton, OH
• Providers in Dayton, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.