Mikka Pendergrass, AGACNP
NPI 1649846304 · Acute Care Nurse Practitioner · Salt Lake City, UT
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mikka Pendergrass, AGACNP is a Acute Care Nurse Practitioner provider in Salt Lake City, UT (NPI 1649846304).
Provider details
- NPI number
- 1649846304
- Entity type
- Individual
- Primary specialty
- Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGACNP
- Sex
- Female
- Sole proprietor
- No
- License
- 86680593102 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
5 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
144 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| New Patient Office Or Other Outpatient Visit With a High Level of Medical Decision Making, If Using Time, 60 Minutes Or More99205 | 41 | $150 |
| Established Patient Office Or Other Outpatient Visit With High Level of Medical Decision Making, If Using Time, 40 Minutes Or More99215 | 36 | $119 |
| Prolonged Office Or Other Outpatient Evaluation and Management Service(s) Beyond the Maximum Required Time of the Primary Procedure Which Has Been Selected Using Total Time on the Date of the Primary Service; Each Additional 15 Minutes By the Physician OrG2212 | 35 | $24 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 20 | $110 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 12 | $80 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-06-02
- Last updated
- 2021-11-11
- Certified
- 2021-11-11
Frequently asked questions
- What is Mikka Pendergrass's NPI number?
- Mikka Pendergrass's National Provider Identifier (NPI) is 1649846304, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mikka Pendergrass's specialty?
- Mikka Pendergrass is listed in the NPPES registry with a primary specialty of Acute Care Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mikka Pendergrass located?
- Mikka Pendergrass's practice location on file with NPPES is 1950 Circle of Hope Dr, Salt Lake City, UT 84112-5500.
- What is Mikka Pendergrass's phone number?
- The practice phone number listed in the NPPES registry for Mikka Pendergrass is (801) 581-2436.
- Does Mikka Pendergrass accept Medicare?
- Mikka Pendergrass is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mikka Pendergrass's NPI active?
- Yes — Mikka Pendergrass's NPI (1649846304) is active in the NPPES registry as of the last update on 2021-11-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.