Active NPI
Melissa Ortiz Pena, MD
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
National Provider Identifier
1043726920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 113548
- Practice address
- 12 Executive Park Dr NE Ste 142
Atlanta, GA 30329-2206 - Phone
- (404) 727-4746
- NPI assigned
- Dec 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 113548 | GA | Primary |
| General Practice Physician | 208D00000X | 21320 | PR |
Addresses
Primary practice location
12 Executive Park Dr NE Ste 142
Atlanta, GA 30329-2206
Mailing address
PO Box 29134
San Juan, PR 00929-0134
Phone (787) 758-2525
Other practice location 1
Univ of PR Medical Science Campus
Main Building Dept of Psychiatry Floor A-994
San Juan, PR 00929-0134
Phone (787) 758-2525 ext. 1923
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21320 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1043726920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29134",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009290134",
"telephone_number": "787-758-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 EXECUTIVE PARK DR NE STE 142",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292206",
"telephone_number": "404-727-4746"
}
],
"practiceLocations": [
{
"address_1": "Univ of PR Medical Science Campus",
"address_2": "Main Building Dept of Psychiatry Floor A-994",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009290134",
"country_code": "US",
"telephone_number": "787-758-2525 x1923",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORTIZ PENA",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-14",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "GA",
"license": "113548",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "21320",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.