Individual provider Active NPI

Karina Pena, PA

  • Medical Physician Assistant
  • San Juan, TX
National Provider Identifier
1104275502
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
801 W 1St St
San Juan, TX 78589-2276
Phone
(956) 787-8915
Fax
(956) 787-2021
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TX Primary

Addresses

Primary practice location

801 W 1St St
San Juan, TX 78589-2276

Mailing address

801 W 1St St
San Juan, TX 78589-2276
Phone (956) 787-8915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215001556 TX Practitioner - Physician Assistant 0244510931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1104275502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W 1ST ST",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785892276",
            "telephone_number": "956-787-8915",
            "fax_number": "956-787-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 1ST ST",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785892276",
            "telephone_number": "956-787-8915",
            "fax_number": "956-787-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "KARINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

Verify at the official NPI Registry.