DEREK PAUL PENDARVIS MD
NPI 1104806108
Surgery in Gainesville, GA

Q: What is Derek Pendarvis's NPI number?

The NPI number for Derek Pendarvis is 1104806108. It was assigned to this individual provider in the NPPES registry on January 18, 2006.

Q: What is Derek Pendarvis's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Pendarvis was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 18, 2006PECOS EnrolledAccepts Medicare Assignment

76.58/100

CMS Quality Rating

725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501(770) 536-2323(770) 536-4947 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Derek Paul Pendarvis Md NPPES

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

DEREK PAUL PENDARVIS MD (NPI 1104806108) is an individual surgery provider in Gainesville, Georgia, licensed in Georgia (049933) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1104806108

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDEREK PAUL PENDARVISCredential: MD

Location Address725 JESSE JEWELL PKWY SEGainesville, GA 30501-3834

Mailing AddressPo Box 658Gainesville, GA 30503-0658 · (770) 718-1122 · Fax (770) 535-7445

Phone(770) 536-2323

Fax(770) 536-4947

Sole ProprietorNo

Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 1996

Enumeration DateJanuary 18, 2006

Last NPPES UpdateMay 22, 2024

NPPES CertifiedMay 22, 2024

✔ NPI 1104806108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in GA · 049933

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

725 JESSE JEWELL PKWY SE, Gainesville, GA 30501

Open in Google Maps ↗

Secondary Practice Locations 5

Location 11270 Friendship RdBraselton, GA 30517-5630 · Phone (770) 536-2323 · Fax (770) 536-4947

Location 21400 River PlBraselton, GA 30517-5600 · Phone (770) 536-2323 · Fax (770) 536-4947

Location 3743 Spring St NEGainesville, GA 30501-3715 · Phone (770) 536-2323 · Fax (770) 536-4947

Location 41945 Beverly RdGainesville, GA 30501-2034 · Phone (770) 536-2323 · Fax (770) 536-4947

Location 5495 Highway 400Dahlonega, GA 30533-6823 · Phone (770) 536-2323 · Fax (770) 536-4947

Other Identifiers 8

Other1700231GA · United Healthcare

Medicaid000904274AGA

Other10045029GA · Amerigroup

Other52843776GA · Bcbs

Medicaid000904274BGA

Other341106GA · Wellcare

Other7816063GA · Cigna

Other20050660GA · Rr Medicare-grp # Cc4177

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek Paul Pendarvis Md 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 ID2466578935

PECOS Enrollment IDI20100922000642

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.

Medicare Billing Reassignments

Medicare enrollment records show Derek Pendarvis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Longstreet Clinic, PC

Same address

Internal Medicine

725 JESSE JEWELL PKWY SE
Gainesville, GA 30501

Reassigned Medicare billing, Georgia enrollment
170 clinicians in this Medicare group

NPI 1326019977 (770) 718-1122

Northeast Georgia Community Physicians LLC

0.1 mi

Internal Medicine

743 SPRING ST NE
Gainesville, GA 30501

Reassigned Medicare billing, Georgia enrollment
161 clinicians in this Medicare group

NPI 1881583730 (770) 219-9000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

149 services149 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

121 services120 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

109 services105 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

66 services65 patients

Fine needle aspiration biopsy using ultrasound guidance, each additional growth 10006

A fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is used to collect cells from a growth. Ultrasound helps accurately locate the growth. If there's more than one growth, each one is biopsied separately.

56 services42 patients

Ultrasonic guidance during surgery 76998

Ultrasonic guidance during surgery is a technique that uses sound waves to create real-time images of the inside of your body. This helps the surgeon navigate and perform procedures more accurately, reducing the risk of complications. It's like a GPS for your body's internal structures.

40 services39 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

24 services24 patients

Removal or exploration of parathyroid glands 60500

The procedure for removal or exploration of parathyroid glands involves a surgeon making a small incision in the neck to locate and remove one or more of the tiny parathyroid glands. These glands control calcium levels in the body. This procedure helps treat conditions like hyperparathyroidism.

20 services20 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

20 services20 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

18 services18 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

18 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

18 services18 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.

17 services17 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

12 services12 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

12 services12 patients

Removal of gallbladder with x-ray study of bile ducts using an endoscope 47563

This procedure, known as an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible camera (endoscope) to examine your bile ducts. If gallstones are found, your gallbladder may be removed in a separate procedure. This helps prevent future complications.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.63

Promoting Interoperability

Improvement Activities

Cost

72.14

Other Providers at the Same Location NPPES 20

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

THE LONGSTREET CLINIC, PC

Clinical Medical Laboratory

725 JESSE JEWELL PKWY SE, SUITE 260
GAINESVILLE, GA 30501

Hall County (770) 535-0079

EILEEN JAVELLANA MD

Internal Medicine