THOMAS W PENDERGRASS M.D., M.S.P.H.
NPI 1124109483
Pediatrics - Pediatric Hematology-Oncology in Seattle, WA

Q: What is Thomas Pendergrass's NPI number?

The NPI number for Thomas Pendergrass is 1124109483. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Q: What is Thomas Pendergrass's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Active since October 17, 2006PECOS Enrolled

4800 SAND POINT WAY NE, SEATTLE, WA 98105(206) 987-2106(206) 987-5105 Get Directions Write a Review

NPPES record last updated: June 18, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Thomas W Pendergrass M.d., M.s.p.h. NPPES

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

THOMAS W PENDERGRASS M.D., M.S.P.H. (NPI 1124109483) is an individual pediatric hematology-oncology provider in Seattle, Washington, licensed in Washington (MD00014612) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124109483

Entity TypeIndividualMale

Primary Taxonomy2080P0207X

Provider Legal NameTHOMAS W PENDERGRASSCredential: M.D., M.S.P.H.

Location Address4800 SAND POINT WAY NESeattle, WA 98105

Mailing AddressPo Box 5371, 4800 Sand Point Way NeSeattle, WA 98145-5005 · (206) 987-2106 · Fax (206) 987-5105

Phone(206) 987-2106

Fax(206) 987-5105

Sole ProprietorNo

Enumeration DateOctober 17, 2006

Last NPPES UpdateJune 18, 2018

✔ NPI 1124109483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0207X

License✔ Licensed in WA · MD00014612

Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Also ListedPediatricsTaxonomy 208000000X · License MD00014612 (WA)

4800 SAND POINT WAY NE, Seattle, WA 98105

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Other Identifiers 2

Other0826Internal Id-motor Vehicle Id

Medicaid8362105WA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas W Pendergrass M.d., M.s.p.h. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Thomas Pendergrass reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Association Of Chmc And University Physicians

Same address

Trauma Surgery

4800 SAND POINT WAY NE
Seattle, WA 98105

Reassigned Medicare billing, Washington enrollment
Medicare enrollment name: The Association Of Chrmc And University Physicians
1,443 clinicians in this Medicare group

NPI 1649497827 (206) 987-2000

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

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.

NALINI MALARKKAN MD

Anesthesiology

4800 SAND POINT WAY NE
SEATTLE, WA 98105

King County (206) 987-2728

MS. LINDA E EBLEN MA

Speech-Language Pathologist

4800 SAND POINT WAY NE, MAIL STOP W-6839
SEATTLE, WA 98105

King County (206) 987-6164

DR. JAMES TOLIVER BENNETT JR. M.D., PH.D.

Medical Genetics (Clinical Molecular Genetics)

4800 SAND POINT WAY NE, GENETIC MEDICINE
SEATTLE, WA 98105

King County (206) 987-2056

DR. LESLIE ANN DERVAN MD

Pediatrics (Pediatric Critical Care Medicine)

4800 SAND POINT WAY NE, MB.10.620
SEATTLE, WA 98105

King County (206) 987-0293

DR. INDI TREHAN MD

Pediatrics (Pediatric Infectious Diseases)

4800 SAND POINT WAY NE
SEATTLE, WA 98105

King County (206) 987-2000

MS. JENNIFER PATANO CNP

Nurse Practitioner (Pediatrics)

4800 SAND POINT WAY NE, MS O.7.720
SEATTLE, WA 98105

King County (206) 987-8949

MRS. SUSAN L HOLTZCLAW ARNP

Nurse Practitioner (Family)

4800 SAND POINT WAY NE, MAILSTOP T-2108
SEATTLE, WA 98105

King County (206) 987-5691

SHENG ZHOU MD

Otolaryngology (Pediatric Otolaryngology)

4800 SAND POINT WAY NE
SEATTLE, WA 98105

King County (206) 987-2105

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 Thomas Pendergrass's NPI number?

The NPI number for Thomas Pendergrass is 1124109483. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Where is Thomas Pendergrass located?

Thomas Pendergrass practices at 4800 Sand Point Way NE, Seattle, WA 98105. The listed phone number is (206) 987-2106.

What is Thomas Pendergrass's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Thomas Pendergrass enrolled in Medicare?

Yes. Thomas Pendergrass is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thomas Pendergrass's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Pendergrass reassigns Medicare benefits to Association Of Chmc And University Physicians (Seattle, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Pendergrass's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thomas Pendergrass was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.