DR. SAMUEL SPARROW PENDERGRAFT PHD, PA-C
NPI 1013492180
Physician Assistant in North Wilkesboro, NC

Active since September 25, 2018PECOS EnrolledAccepts Medicare Assignment
1900 W PARK DR STE C, NORTH WILKESBORO, NC 28659(336) 903-6920(336) 903-6921 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 8, 2022, Sep 25, 2018 (2 updates tracked since 2018).

About Dr. Samuel Sparrow Pendergraft Phd, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL SPARROW PENDERGRAFT PHD, PA-C (NPI 1013492180) is an individual physician assistant in North Wilkesboro, North Carolina, licensed in North Carolina (0010-08261) and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS, is affiliated with North Carolina Baptist Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1013492180
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDR. SAMUEL SPARROW PENDERGRAFTCredential: PHD, PA-C
Location Address1900 W PARK DR STE CNorth Wilkesboro, NC 28659-3563
Mailing Address1900 W Park Dr Ste CNorth Wilkesboro, NC 28659-3563 · (336) 903-6920 · Fax (336) 903-6921
Fax(336) 903-6921
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateSeptember 25, 2018
Last NPPES UpdateFebruary 8, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2022
NPI 1013492180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NC · 0010-08261
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1900 W PARK DR STE C, North Wilkesboro, NC 28659

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel Sparrow Pendergraft Phd, Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123364296
PECOS Enrollment IDI20190110000569
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of tissue from wound, 20.0 sq cm or less 97597
This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
72 services12 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
66 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340047
LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County
Emergency services Birthing friendly

Wilkes Regional Medical Center

Acute Care Hospitals · North Wilkesboro, NC
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340064
Location1370 West D StNorth Wilkesboro, NC 28659 · Wilkes County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28659 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
2 suppliers45 claims2,020 services$0.10 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
2 suppliers22 claims1,088 services$0.37 avg. paid by Medicare
Collagen dressing, sterile, size 16 sq. in. or less, each A6021
DME-Medical/Surgical Supplies · category DA023N
2 suppliers15 claims331 services$20.23 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
3 suppliers47 claims1,473 services$7.02 avg. paid by Medicare
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6216
DME-Medical/Surgical Supplies · category DA023N
2 suppliers60 claims13,000 services$0.04 avg. paid by Medicare
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6222
DME-Medical/Surgical Supplies · category DA023N
2 suppliers15 claims509 services$1.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
1900 W PARK DR STE C
NORTH WILKESBORO, NC 28659

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Pendergraft's NPI number?

The NPI number for Samuel Pendergraft is 1013492180. It was assigned to this individual provider in the NPPES registry on September 25, 2018.

Where is Samuel Pendergraft located?

Samuel Pendergraft practices at 1900 W Park Dr Ste C, North Wilkesboro, NC 28659. The listed phone number is (336) 903-6920.

What is Samuel Pendergraft's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Samuel Pendergraft enrolled in Medicare?

Yes. Samuel Pendergraft is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samuel Pendergraft accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC and 2 other insurers list Samuel Pendergraft as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Pendergraft affiliated with any hospitals?

According to CMS data, Samuel Pendergraft is affiliated with North Carolina Baptist Hospital and Wilkes Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Samuel Pendergraft was last updated on February 8, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.