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MR. JUSTIN POTTER PENDERGRAST PA-C
NPI 1972692887
Physician Assistant in Albany, NY

Active since October 11, 2006PECOS EnrolledAccepts Medicare Assignment
43 NEW SCOTLAND AVE, ALBANY, NY 12208(518) 262-6575 Get Directions Write a Review

NPPES record last updated: July 15, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Justin Potter Pendergrast Pa-c NPPES

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

MR. JUSTIN POTTER PENDERGRAST PA-C (NPI 1972692887) is an individual physician assistant in Albany, New York, licensed in New York (009621) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Ellis Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1972692887
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JUSTIN POTTER PENDERGRASTCredential: PA-C
Location Address43 NEW SCOTLAND AVEAlbany, NY 12208-3412
Mailing Address1462 Erie BlvdSchenectady, NY 12305-1026 · (518) 243-1020
Phone(518) 262-6575
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateOctober 11, 2006
Last NPPES UpdateJuly 15, 2008
✔ NPI 1972692887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 009621
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.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 009621 (NY)
43 NEW SCOTLAND AVE, Albany, NY 12208
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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

Mr. Justin Potter Pendergrast 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 ID2567449143
PECOS Enrollment IDI20040701000752
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.

Hospital Affiliations CMS Care Compare

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

Ellis Hospital

Acute Care Hospitals · Schenectady, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330153
Location1101 Nott StreetSchenectady, NY 12308 · Schenectady County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12208 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

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.

MS. KELLY N MILES MS, RNC, NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 262-9200
DR. NATHANIEL FRANCIS EKSTROM DO
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE, DEPT. OF EMERGENCY MEDICINE, MAIL CODE: 139
ALBANY, NY 12208
Albany County (518) 262-6455
JESSICA MARIE CARPENTER
Nurse Anesthetist, Certified Registered
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 332-3956
MS. RACHAEL RENEE GREY CNIM
Specialist/Technologist, Other (Electroneurodiagnostic)
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 262-3125
JOSNEL CID
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 262-6488
DR. JOANNA MIDURA PALUCH DO
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 262-0144
RITIKA PATEL
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Albany County (518) 262-3125
MISS CRISTINA LYNN SILVA MS CCC SLP
Speech-Language Pathologist
43 NEW SCOTLAND AVE, COMMUNICATION DISORDERS DEPARTMENT MC 128
ALBANY, NY 12208
Albany County (518) 262-4526

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 Justin Pendergrast's NPI number?

The NPI number for Justin Pendergrast is 1972692887. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Justin Pendergrast located?

Justin Pendergrast practices at 43 New Scotland Ave, Albany, NY 12208. The listed phone number is (518) 262-6575.

What is Justin Pendergrast's specialty?

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

Is Justin Pendergrast enrolled in Medicare?

Yes. Justin Pendergrast 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.

Is Justin Pendergrast affiliated with any hospitals?

According to CMS data, Justin Pendergrast is affiliated with Ellis Hospital.

When was this NPI record last updated?

The NPPES record for Justin Pendergrast was last updated on July 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.