MICHAEL JR. PENDERGAST (PA-C) – Physician Assistant, NPI 1427525666
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MICHAEL JR. PENDERGAST (PA-C)
391 S Bolingbrook Dr
Bolingbrook, IL 604403411
Phone: (630) 226-1006
Type: Location
1010 CURTISS ST APT B1
DOWNERS GROVE, IL 605154518
Phone: (309) 331-3448
Type: Mailing
West Higgins Road, Rosemont, Leyden Township, Cook County, Illinois, 60631, United States
ROSEMONT, IL 600184703
Phone: (847) 692-3715
Fax: (815) 986-4218
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $24.
Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.
Last reported payment date: 2023-11-29 • Largest payer in this snapshot: Melinta Therapeutics, LLC ($24).
Total Amount
$24
General + Research + Ownership
Payments
1
Total payment records
General Amount
$24
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Melinta Therapeutics, LLC | $24 |
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: 2019-01-11
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 |
|---|---|---|---|---|
| I20190111000485 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 102 | 101 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 30 | 30 | $0 |
Insurance plans in this area (ZIP 60440)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MI | |
| Physician Assistant | IL | |
| - | NY | |
| Physician Assistant | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | MI | |
| Physician Assistant | IL |
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