Active NPI
Lauren M Pendergast, R.D.
- Registered Dietitian
- New York, NY
National Provider Identifier
1780005017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN-0000539
- Practice address
- 630 W 168TH St
New York, NY 10032-3725 - Phone
- (215) 628-4454
- Fax
- (302) 651-2757
- NPI assigned
- Jan 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN-0000539 | DE | Primary |
Addresses
Primary practice location
630 W 168TH St
New York, NY 10032-3725
Mailing address
725 Skippack Pike Ste 300
Blue Bell, PA 19422-1749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN-0000539 | DE | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1780005017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 SKIPPACK PIKE STE 300",
"city": "BLUE BELL",
"state": "PA",
"postal_code": "194221749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323725",
"telephone_number": "215-628-4454",
"fax_number": "302-651-2757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDERGAST",
"first_name": "LAUREN",
"middle_name": "M",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-06",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "DE",
"license": "DN-0000539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.