Jared Allen Pendergrass, PA-C
NPI 1780282863ActiveIndividual· Physician Assistant· Aurora, MO
Physician Assistant (PA-C) in Aurora, Missouri, licensed in MO, with an NPI issued in October 2020. Part D covered 335 prescriptions written in 2024, 96% of them generic.
Overview
| NPI | 1780282863 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Oct 12, 2020 |
| Last updated in NPPES | Oct 27, 2020 |
| Certified by provider | Oct 27, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 2020009814 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MO) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 335 · 339 30-day fills |
|---|---|
| Patients | 213 |
| Total drug cost | $2,849 |
| Generic share | 96% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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