JAYNEE E PENDERGAST (DO) – Family Medicine Physician, NPI 1235519901
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,037 FAMILY PRACTICE in IL
Provider Addresses for JAYNEE E PENDERGAST (DO)
101 S PRAIRIE AVE
DWIGHT, IL 604201350
Phone: (815) 584-3291
Fax: (815) 584-3475
Type: Location
885 Roosevelt Rd Ste 100
Glen Ellyn, IL 601376141
Phone: (630) 384-6200
Fax: (630) 384-6229
Type: Location
101 S Prairie Ave
Dwight, IL 604201350
Phone: (815) 584-3291
Fax: (815) 584-3475
Type: Location
389 E Main St
Braidwood, IL 604082010
Phone: (815) 458-2532
Fax: (815) 458-2455
Type: Location
135 N Oak St
Hinsdale, IL 605213860
Phone: (630) 856-8900
Fax: (630) 856-8933
Type: Location
725 SCHOOL ST STE A
MORRIS, IL 604501207
Phone: (815) 941-9124
Fax: (815) 941-4363
Type: Mailing
1345 EDWARDS ST STE 2
MORRIS, IL 604501692
Phone: (815) 942-1421
Fax: (815) 488-2033
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: 2017-10-24
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 |
|---|---|---|---|---|
| I20171024002323 | I | Family Practice | IL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 45 | 44 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 25 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 60420)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Family Practice | IL | |
| Family Practice | IL | |
| Family Practice | IL | |
| - | IL | |
| - | IL | |
| Clinical Psychologist | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Family Practice, Osteopathic Manipulative Medicine | IL |
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