Individual provider Active NPI

Christopher John Prendergast, MD

  • Pediatrics Physician
  • Syracuse, NY
National Provider Identifier
1760700108
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
291866 Issued in NY
Practice address
725 Irving Ave Ste 804
Syracuse, NY 13210-1682
Phone
(315) 214-7700
Fax
(315) 214-7701
NPI assigned
May 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 291866 NY
Pediatrics Physician 208000000X 291866 NY Primary

Addresses

Primary practice location

725 Irving Ave Ste 804
Syracuse, NY 13210-1682

Mailing address

725 Irving Ave Ste 804
Syracuse, NY 13210-1682
Phone (315) 214-7700

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cprendergast210161@direct.urmc.rochester.edu Direct
Direct Messaging Address cprendergast210161@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180416000181 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 2163654716 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
Warren Alpert Medical School of Brown University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Cardiology Associates, LLCGroup PAC ID 1153383773, 7 clinicians

Practice addresses (Care Compare)

725 Irving Ave
Suite 804
Syracuse, NY 13210-1682
Phone (315) 214-7700

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
291866NYMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Cardiology Pediatrics CurrentSince Apr 1, 2020 Accepting new patients
Gouverneur Hospital CurrentSince Jan 26, 2022 Accepting new patients
Massena Hospital Inc CurrentSince Jan 26, 2022 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Feb 16, 2019 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jan 26, 2022 Accepting new patients
Gouverneur Hospital CurrentSince Jan 26, 2022 Accepting new patients
Pediatric Cardiology Associates, LLC Pediatric Cardiology CurrentSince Feb 19, 2018 Accepting new patients
Massena Hospital, Inc CurrentSince Jan 26, 2022 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jan 26, 2022 Accepting new patients
Delaware Valley Hospital, Inc Past Accepting new patients

Locations

1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

725 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

725 Irving Ave
Ste 804
Syracuse, NY 13210
Phone (315) 214-7700

Interoperability endpoints

  • Direct secure messaging: cprendergast210161@direct.urmc.rochester.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1760700108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 804",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101682",
            "telephone_number": "315-214-7700",
            "fax_number": "315-214-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE STE 804",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101682",
            "telephone_number": "315-214-7700",
            "fax_number": "315-214-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "291866",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "291866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cprendergast210161@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cprendergast210161@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.