NPIMap

Individual provider Active NPI

Eric A Pena, MD FACC

  • Clinical Cardiac Electrophysiology Physician
  • Medford, OR
National Provider Identifier
1093703563
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
24394 Issued in OR
Practice address
520 Medical Center Dr
Suite 200
Medford, OR 97504-4314
Phone
(541) 282-6606
Fax
(541) 282-6601
NPI assigned
Oct 10, 2005
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 24394 OR Primary

Addresses

Primary practice location

520 Medical Center Dr
Suite 200
Medford, OR 97504-4314

Mailing address

520 Medical Center Dr
Suite 200
Medford, OR 97504-4314
Phone (541) 282-6606

Other identifiers 1

IdentifierTypeStateIssuer
227007MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000320 OR Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 3678471141 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Florida College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians
Asante Three Rivers Medical Center LLCGroup PAC ID 9931197993, 98 clinicians
Southern Oregon Cardiology LLCGroup PAC ID 2264572510, 28 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

520 Medical Ctr Dr
Suite 200
Medford, OR 97504-4314
Phone (541) 930-7222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8559NVMDSocial Worker
24394ORMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oregon Cardiology LLC CurrentSince Jan 1, 2010 Accepting new patients
Asante CurrentSince Jul 1, 2003 Accepting new patients
Asante Ashland Community Hospital, LLC CurrentSince May 1, 2018 Accepting new patients
Asante CurrentSince Jul 1, 2003 Accepting new patients
Asante Three Rivers Medical Center, LLC CurrentSince Jan 6, 2010 Accepting new patients
Cardiovascular Consultants of Nevada Clinical Cardiac Electrophysiology Past Accepting new patients

Locations

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

520 SW Ramsey Ave
Ste 204
Grants Pass, OR 97527
Phone (541) 479-8308

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

520 Medical Center Dr
Ste 200
Medford, OR 97504
Phone (541) 282-6600

Organizations & group practices 6

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

Hospital & facility affiliations 7

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1093703563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "SUITE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-282-6606",
            "fax_number": "541-282-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "SUITE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-282-6606",
            "fax_number": "541-282-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ERIC",
        "middle_name": "A",
        "credential": "MD FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "OR",
            "license": "24394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227007",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.