NICOLE JEAN PRENDERGAST – Sports Medicine (Emergency Medicine) Physician, NPI 1073018081
Sports Medicine (Emergency Medicine) Physician
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Profile Insights
NPPES metrics only — not quality of care.
5,791 EMERGENCY MEDICINE in CA
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Provider Addresses for NICOLE JEAN PRENDERGAST
900 Welch Road, Welch Road, Stanford, Palo Alto, Santa Clara County, California, 94305-6015, United States
PALO ALTO, CA 943041805
Phone:
Type: Mailing
900 Welch Rd
Palo Alto, CA 943041805
Phone: (650) 723-9215
Type: Location
3601 The Vanderbilt Clinic
Nashville, TN 372321805
Phone: (615) 322-5000
Type: Location
MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 271570001
Phone: (336) 716-2255
Type: Mailing
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE, TN 372152691
Phone: (615) 322-5000
Type: Mailing
3601 THE VANDERBILT CLINIC
NASHVILLE, TN 372321805
Phone: (615) 322-5000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-08-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230802004195 | I | Emergency Medicine | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 82 | 81 | $0 |
| 99291 | Critical care, first 30-74 minutes | 20 | 20 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 16 | 16 | $0 |
Insurance plans in this area (ZIP 94304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | PA | |
| - | NC | |
| P O D I A T R Y | NC | |
| Diagnostic Radiology | NC | |
| - | NC | |
| A N E S T H E S I O L O G Y | MI | |
| - | NC | |
| Orthopedic Surgery | TX | |
| Physician Assistant | NC | |
| - | NC |
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