Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Paul Pendarvis, MD

Individual provider Surgery Physician · NPI 1104806108

Derek Paul Pendarvis, MD is a General Surgery in Gainesville, Georgia. Graduated from Medical University of South Carolina College of Medicine in 1996, 30 years ago. Practices with The Longstreet Clinic, PC, a 142-clinician group, works from 6 locations, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
30
Trained at
Medical University of South Carolina College of Medicine
Licensed in
GA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone: (770) 536-2323
Fax: (770) 536-4947
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1270 Friendship Rd, Braselton, GA 30517-5630 — (770) 536-2323
  • 1400 River Pl, Braselton, GA 30517-5600 — (770) 536-2323
  • 495 Highway 400, Dahlonega, GA 30533-6823 — (770) 536-2323
  • 743 Spring St Ne, Gainesville, GA 30501-3715 — (770) 536-2323
  • 1945 Beverly Rd, Gainesville, GA 30501-2034 — (770) 536-2323

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 049933 (GA)

Record details

NPI number1104806108
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 18, 2006
Last updated in NPPESMay 22, 2024
Certification dateMay 22, 2024
Mailing addressPo Box 658, Gainesville, GA 30503-0658

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 1996 (30 years in practice)
Group practice The Longstreet Clinic, Pc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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