Individual provider Active NPI

Raymond J Pena, M.D.

  • Family Medicine Physician
  • Reedley, CA
National Provider Identifier
1003836974
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A61340 Issued in CA
Practice address
1415 N Acacia Ave
Suite 101
Reedley, CA 93654-2449
Phone
(559) 638-8187
Fax
(559) 638-3883
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A61340 CA Primary

Addresses

Primary practice location

1415 N Acacia Ave
Suite 101
Reedley, CA 93654-2449

Mailing address

1415 N Acacia Ave
Suite 101
Reedley, CA 93654-2449
Phone (559) 638-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000700 CA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 0749265759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Medical College of Pennsylvania, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soledad Community Health Care DistrictGroup PAC ID 4385635085, 12 clinicians

Practice addresses (Care Compare)

600 Main St
Soledad, CA 93960-2533
Phone (831) 678-2665

Hospital & facility affiliations

  • Central Coast Vna & Hospice, Inc Home health agency, Monterey, CA, CCN 057002
  • Salinas Valley Health Medical Center Hospital, Salinas, CA, CCN 050334
  • Southern Monterey County Memorial Hospital Hospital, King City, CA, CCN 051336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61340CAMDPharmacist
A61340CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Soledad Community Health Care District Family Medicine CurrentSince Feb 26, 2019 Accepting new patients
Eden Valley Care Center CurrentSince Feb 26, 2019 Accepting new patients

Locations

600 Main St
Soledad, CA 93960
Phone (831) 678-2665

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23190/brand/1/csg/1/fhir/r4
  • Direct secure messaging: raymond.pena.1@23190.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1003836974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N ACACIA AVE",
            "address_2": "SUITE 101",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936542449",
            "telephone_number": "559-638-8187",
            "fax_number": "559-638-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N ACACIA AVE",
            "address_2": "SUITE 101",
            "city": "REEDLEY",
            "state": "CA",
            "postal_code": "936542449",
            "telephone_number": "559-638-8187",
            "fax_number": "559-638-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "RAYMOND",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A61340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedley, CA

Sources for this page

Verify at the official NPI Registry.