Individual provider Active NPI

Pedro J Penalo, MD

  • Internal Medicine Physician
  • Weslaco, TX
National Provider Identifier
1104920859
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L7842 Issued in TX
Practice address
906 S Bridge Ave
Weslaco, TX 78596
Phone
(956) 447-8600
Fax
(956) 447-0335
NPI assigned
Sep 12, 2006
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L7842 TX Primary

Addresses

Primary practice location

906 S Bridge Ave
Weslaco, TX 78596

Mailing address

P.O. Box 1145
Weslaco, TX 78599
Phone (956) 447-8600

Other identifiers 1

IdentifierTypeStateIssuer
173357802MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223001170 TX Practitioner - Internal Medicine 0345136891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pedro J. Penalo, M.D., PLLCGroup PAC ID 9032396445, 2 clinicians

Practice addresses (Care Compare)

330 N Ohio Ave
Mercedes, TX 78570-2728
Phone (956) 565-1561

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L7842TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pedro J. Penalo, M.D., PLLC Internal Medicine CurrentSince Mar 3, 2011 Accepting new patients
Jose F. Pena, MD & Associates PA Past Accepting new patients

Locations

330 N Ohio Ave
Mercedes, TX 78570
Phone (956) 565-1561

906 S Bridge Ave
Weslaco, TX 78596
Phone (956) 447-8600

Organizations & group practices 2

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 5

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1104920859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1145",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78599",
            "telephone_number": "956-447-8600",
            "fax_number": "956-447-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S BRIDGE AVE",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-447-8600",
            "fax_number": "956-447-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENALO",
        "first_name": "PEDRO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L7842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173357802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

Verify at the official NPI Registry.