KELLY M PENDRICK (DR. AUDIOLOGY) – Audiologist, NPI 1093780819

KELLY M PENDRICK (DR. AUDIOLOGY) is a healthcare provider. based in Cadillac, Michigan. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials DR. AUDIOLOGY. They hold a License No. 01090379 (MI). The NPI Number for KELLY M PENDRICK (DR. AUDIOLOGY) is 1093780819

Main info

Female
36 Years Of Experience
Accepts Medicare Assignment
Name
KELLY M PENDRICK (DR. AUDIOLOGY)
NPI
1093780819
Phone
(231) 775-9398
Address
8872 PROFESSIONAL DR
Enumeration Date
23 February 2006
Last Update Date
24 October 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2317796260
Graduation Year
1990 (36 years ago)
PAC ID
0244428506
Group Practice PAC ID
4981884806
Professional Enrollment ID
I20101230000737
Address ID
MI496018482CA8872XDRXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

302 QUALIFIED AUDIOLOGIST in MI

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Provider Addresses for KELLY M PENDRICK (DR. AUDIOLOGY)

  • Cadillac Dynamic Physical Therapy, 8872, Professional Drive, Clam Lake Township, Wexford County, Michigan, 49601, United States

    CADILLAC, MI 496018481

    Phone: (231) 775-9398

    Fax: (231) 775-9398

    Mailing address matches the actual address.

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: 2010-12-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101230000737IQualified AudiologistMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981884806View full group profile
NameSpecialtyState
Qualified AudiologistMI
Otolaryngology, Plastic And Reconstructive SurgeryMI

Reviews

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Frequently asked questions

Is there an official ID for KELLY M PENDRICK (DR. AUDIOLOGY) in U.S. healthcare records?
The official identifier for KELLY M PENDRICK (DR. AUDIOLOGY) is NPI 1093780819.
Is KELLY M PENDRICK (DR. AUDIOLOGY) still an active registrant?
KELLY M PENDRICK (DR. AUDIOLOGY) carries an active NPI according to the public dataset.
What kind of doctor is KELLY M PENDRICK (DR. AUDIOLOGY)?
KELLY M PENDRICK (DR. AUDIOLOGY) is associated with Audiologist in the directory — Clinical services aligned with this taxonomy classification.
Is KELLY M PENDRICK (DR. AUDIOLOGY) associated with Cadillac?
Public fields place KELLY M PENDRICK (DR. AUDIOLOGY) around Cadillac, Michigan. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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