MRS. KELLEY ANN PRENDERGAST (PA) – Physician Assistant, NPI 1033189352
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,091 PHYSICIAN ASSISTANT in MA
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Provider Addresses for MRS. KELLEY ANN PRENDERGAST (PA)
326, Nichols Road, Fitchburg, Worcester County, Massachusetts, 01420, United States
FITCHBURG, MA 01420
Phone: (978) 878-8100
Fax: (978) 878-8537
Type: Mailing
175, Connors Street, Gardner, Worcester County, Massachusetts, 01440, United States
GARDNER, MA 01440
Phone: (978) 410-6121
Fax: (978) 410-6109
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: 2014-09-04
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 |
|---|---|---|---|---|
| I20140904000859 | I | Physician Assistant | MA | 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 |
|---|---|---|---|---|
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 29 | 21 | $0 |
| 83036 | Hemoglobin a1c level | 22 | 20 | $0 |
Insurance plans in this area (ZIP 01420)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | NJ | |
| P O D I A T R Y | NH | |
| - | MA | |
| Family Practice | MA | |
| Mental Health Counselor | MA | |
| - | MA | |
| Nurse Practitioner | MA | |
| - | MA | |
| Nurse Practitioner | MA | |
| Nurse Practitioner | MA |
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