NPIMap

Individual provider Active NPI

Maria Alejandra De la Pena, M.D

  • Pain Medicine (Anesthesiology) Physician
  • Fort Lauderdale, FL
National Provider Identifier
1245402635
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME114029 Issued in FL
Practice address
4800 NE 20TH Terrace
Suite 404, Building C
Fort Lauderdale, FL 33308
Phone
(305) 974-5533
Fax
(305) 974-5553
NPI assigned
Mar 26, 2008
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Anesthesiology) Physician 207LP2900X ME114029 FL Primary

Addresses

Primary practice location

4800 NE 20TH Terrace
Suite 404, Building C
Fort Lauderdale, FL 33308

Mailing address

PO Box 223190
Hollywood, FL 33022-3190
Phone (305) 974-5533

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
I20130925000533 FL Practitioner - Pain ManagementPractitioner - Anesthesiology 8022252402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christian Gonzalez MD LLCGroup PAC ID 9335389659, 8 clinicians

Practice addresses (Care Compare)

4800 NE 20TH Terrace
Suite 404 Building C
Ft Lauderdale, FL 33308-4500
Phone (305) 974-5533

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Gonzalez, MD, LLC Pain Medicine CurrentSince Mar 1, 2016 Accepting new patients

Locations

4800 NE 20th Ter
Ste 404
Ft Lauderdale, FL 33308
Phone (954) 491-4950

1928 Tyler St
Hollywood, FL 33020
Phone (305) 974-5543

21000 NE 28th Ave
Ste 104
Miami, FL 33180
Phone (305) 933-0626

21097 NE 27th Ct
Ste 320
Miami, FL 33180
Phone (305) 933-8465

Networks

  • HealthSun Health Plans Network

Interoperability endpoints

  • Direct secure messaging: aventuraspineandwellnesscenter.mariadelapena@125092.advancedmd-direct.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 8

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": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1245402635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223190",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330223190",
            "telephone_number": "305-974-5533",
            "fax_number": "305-974-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE 20TH TERRACE",
            "address_2": "SUITE 404, BUILDING C",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "305-974-5533",
            "fax_number": "305-974-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PENA",
        "first_name": "MARIA",
        "middle_name": "ALEJANDRA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME114029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.