NPIMap

Individual provider Active NPI

Richard J Pena -Ariet, MD

  • Internal Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1225015852
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME81092 Issued in FL
Practice address
1420 SW Saint Lucie West Blvd Ste 107
Port Saint Lucie, FL 34986-1709
Phone
(772) 879-1112
Fax
(772) 879-1167
NPI assigned
Dec 23, 2005
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 ME81092 FL Primary

Addresses

Primary practice location

1420 SW Saint Lucie West Blvd Ste 107
Port Saint Lucie, FL 34986-1709

Mailing address

1420 SW Saint Lucie West Blvd
Ste 107
Port Saint Lucie, FL 34986-1709
Phone (772) 879-1112

Other identifiers 3

IdentifierTypeStateIssuer
010639109OtherFLCOMMERCIAL INSURANCE
010639109MedicaidFL
58575OtherFLBCBS OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071214000097 FL Practitioner - Internal Medicine 8325138332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard J Pena- Ariet MD PAGroup PAC ID 4183705445, 5 clinicians

Practice addresses (Care Compare)

1420 SW Saint Lucie W Blvd
Suite 107
Port St Lucie, FL 34986-1709
Phone (772) 879-1112

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME81092FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard J Pena- Ariet MD PA Internal Medicine CurrentSince Nov 1, 2006 Accepting new patients

Locations

1420 SW Saint Lucie West Blvd
Ste 107
Port St Lucie, FL 34986
Phone (772) 336-6881

1631 NW Saint Lucie West Blvd
Ste 208
Port St Lucie, FL 34986
Phone (772) 672-0897

Interoperability endpoints

  • Direct secure messaging: richard.pena-ariet@7640482381828.direct.elationemr.com

Organizations & group practices 1

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 10

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1225015852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD",
            "address_2": "STE 107",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-879-1112",
            "fax_number": "772-879-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD STE 107",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-879-1112",
            "fax_number": "772-879-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA -ARIET",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME81092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "010639109",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010639109",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "58575",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.