Jose Antonio Penaherrera, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036095226 Issued in IL

Practice address

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9524

Phone

(815) 727-4292

Fax

(815) 727-5395

NPI assigned

Feb 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Southern Illinois University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seven Star Hospital Associates IncGroup PAC ID 4789083338, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Direct Provider of Healthcare Services, Inc Home health agency, Rancho Cucamonga, CA, CCN 059415
• Hemet Global Medical Center Hospital, Hemet, CA, CCN 050390

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Seven Star Hospital Associates Inc.

  • Diagnostic Radiology Physician
  • Hemet, CA
  • NPI 1043813140
  Medicare reassignment Care Compare group NPD
• Seven Star Hospital Associates Inc.

  • Hospitalist Physician
  • Hemet, CA
  • NPI 1942803044
  NPD

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

• Direct Provider of Healthcare Services, Inc.

  • Home Health Agency
  • Rancho Cucamonga, CA
  • NPI 1003056292
  Care Compare affiliation
• KPC Global Medical Centers, Inc.

  • General Acute Care Hospital
  • Hemet, CA
  • NPI 1114239068
  Care Compare affiliation

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1073649141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "SUITE 265",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "815-727-4292",
            "fax_number": "815-727-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "SUITE 265",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519524",
            "telephone_number": "815-727-4292",
            "fax_number": "815-727-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENAHERRERA",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "9928146",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine D Patterson, PHARM D
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• Internal Medicine Physician in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.