Stephanie Hue Pendergrass, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD2014-0832 Issued in NM

Practice address

11120 Malaguena LN NE
Albuquerque, NM 87111-6861

Phone

(505) 401-8956

NPI assigned

Apr 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Stephanie Jane Hue Former name

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spendergrass80624@direct.phs.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.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354

  NM, Pediatrics

  Medicare reassignment NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1790959203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 MALAGUENA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116861",
            "telephone_number": "505-401-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 MALAGUENA LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116861",
            "telephone_number": "505-401-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "STEPHANIE",
        "middle_name": "HUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2014-0832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HUE",
            "middle_name": "JANE",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rodolfo Cesar Pena, PHD
• Selina Pena
• Veronica Pena
• Martina Penalosa, MD, MPH
• Luis David Penaloza Vargas
• Michael Pendleton, D.C., D.A.C.N.B
• Tiffany Ann Pendleton, D.O.
• Annisa Suzette Penfold, PTA
• Vicky Peng, MD
• Jessica Penick, MS, CCC-SLP

• All providers in Albuquerque, NM
• Pediatrics Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.