Active NPI
Robert C Pendleton, M.D.
- Internal Medicine Physician
- Columbia, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2020038381
- Practice address
- 1 Hospital Dr
Columbia, MO 65212-0001 - Phone
- (573) 884-9066
- Fax
- (573) 884-3037
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 364430-1205 | UT | |
| Internal Medicine Physician | 207R00000X | 2020038381 | MO | Primary |
Addresses
Primary practice location
1 Hospital Dr
Columbia, MO 65212-0001
Mailing address
PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002088793 | Medicaid | NV | |
| D3387 | Medicaid | UT | |
| 805974100 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Baylor College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020038381 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| SSM Health Care Group | Internal Medicine | Current | Accepting new patients |
Locations
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
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- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Endocrinology, Diabetes & Metabolism Physician
- Salt Lake City, UT
- NPI 1588068381
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1942685920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1851314132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843966",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843966",
"telephone_number": "573-884-3300",
"fax_number": "573-884-0943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-884-9066",
"fax_number": "573-884-3037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDLETON",
"first_name": "ROBERT",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "364430-1205",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2020038381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002088793",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D3387",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805974100",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.