Individual provider Active NPI

Carlos J Pena, PA-C

  • Physician Assistant
  • Carmichael, CA
National Provider Identifier
1245687052
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA53458 Issued in CA
Practice address
6305 Coyle Ave
Carmichael, CA 95608-0438
Phone
(916) 535-2000
Fax
(916) 408-8000
NPI assigned
May 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA53458 CA Primary

Addresses

Primary practice location

6305 Coyle Ave
Carmichael, CA 95608-0438

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160831001657 CA Practitioner - Physician Assistant 7517253586 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
77.6
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA53458CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Mar 16, 2025 Accepting new patients
Cep America - California CurrentSince Feb 1, 2022 Accepting new patients
Regents of the University of Ca CurrentSince Mar 16, 2025 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

1325 Cottonwood St
Woodland, CA 95695
Phone (530) 662-3961

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1245687052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080438",
            "telephone_number": "916-535-2000",
            "fax_number": "916-408-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "CARLOS",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-21",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.