FRED PRENDERGASS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104855345

FRED PRENDERGASS (CRNA) is a healthcare provider. based in Fairfax, Virginia. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 26NJ00212000 (NJ). The NPI Number for FRED PRENDERGASS (CRNA) is 1104855345

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
FRED PRENDERGASS (CRNA)
NPI
1104855345
Phone
(703) 295-9360
Address
3998 FAIR RIDGE DR
Enumeration Date
1 July 2006
Last Update Date
19 March 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2019152000
Graduation Year
1999 (27 years ago)
PAC ID
9638152366
Group Practice PAC ID
5193137503
Professional Enrollment ID
I20040615000458
Address ID
NJ073024321JE355XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,121 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in NJ

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Provider Addresses for FRED PRENDERGASS (CRNA)

  • 3998, Fair Ridge Drive, Pender, Chantilly, Fairfax (city), Virginia, 22033, United States

    SUITE 300

    FAIRFAX, VA 220332907

    Phone: (703) 295-9360

    Fax: (703) 766-9725

    Type: Mailing

  • Jersey City Medical Center, 355, Grand Street, Jersey City, Hudson County, New Jersey, 07302, United States

    JERSEY CITY, NJ 073024321

    Phone: (201) 915-2405

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Haemonetics Corporation ($20).

Total Amount

$39

General + Research + Ownership

Payments

2

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-06-15

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
I20040615000458ICertified Registered Nurse Anesthetist (Crna)NJTBD

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 22033)

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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: 5193137503View full group profile
NameSpecialtyState
Diagnostic RadiologyNJ
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)NY
Diagnostic RadiologyMA
Certified Registered Nurse Anesthetist (Crna)CA
A N E S T H E S I O L O G YNY
Nurse PractitionerNJ
Diagnostic RadiologyNJ
Internal Medicine, Pulmonary DiseaseNJ
Physician AssistantNJ

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Frequently asked questions

What is the standard ID for FRED PRENDERGASS (CRNA) in the U.S.?
In the U.S., FRED PRENDERGASS (CRNA) is identified by NPI 1104855345.
Should I treat FRED PRENDERGASS (CRNA) as an active provider?
Patients and plans typically see FRED PRENDERGASS (CRNA) as active in the national extract.
What services align with FRED PRENDERGASS (CRNA)'s listing?
FRED PRENDERGASS (CRNA)'s public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to FRED PRENDERGASS (CRNA)?
FRED PRENDERGASS (CRNA) is associated with Fairfax, Virginia in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.