Kevin Michael Peno, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA061829 Issued in PA

Practice address

1951 Pine Hall Rd Ste 225
State College, PA 16801-5107

Phone

(814) 237-0001

NPI assigned

Sep 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis Lifecare LLCGroup PAC ID 2860796323, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Oasis Lifecare LLC

  • Psychiatry Physician
  • State College, PA
  • NPI 1013398130

  PA

  Medicare reassignment Care Compare group
• Mount Nittany Medical Center Health Services Inc

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554

  PA

  Medicare reassignment NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868

  PA

  Medicare reassignment
• Geisinger Clinic

  • Internal Medicine Physician
  • Wilkes Barre, PA
  • NPI 1114295565
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1104430503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 THOMPSON ST",
            "city": "LEMONT",
            "state": "PA",
            "postal_code": "168519068",
            "telephone_number": "814-769-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 PINE HALL RD STE 225",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015107",
            "telephone_number": "814-237-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENO",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn State Hershey Endoscopy Center LLC
• Pennsylvania CVS Pharmacy LLC
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.
• Peter F. Pepe, M.D.
• Jennifer L Pepperman, LCSW
• Perla Lifecare Nursing Services Inc
• Louis Anthony Persic, MD
• Denise Cheryl Person, PHD

• Physician Assistant in State College, PA
• Providers in State College, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.
• 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.