Juan Pena

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

213E00000X Issued in NY

Practice address

1831 Grand Concourse
Bronx, NY 10453-6323

Phone

(718) 365-6691

Fax

(718) 364-7777

NPI assigned

Sep 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1255733523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536323",
            "telephone_number": "718-365-6691",
            "fax_number": "718-364-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104536323",
            "telephone_number": "718-365-6691",
            "fax_number": "718-364-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JUAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NY",
            "license": "111NN0400X",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "213E00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUPER1626",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Pena
• Israel Pena
• Jael M Pena
• Jessica Pena, M.D.
• Josefina Pena
• Keershe Lee Pena
• Leini Pena
• Lisandra Pena, R.N
• Maria Carmen Pena, LMSW
• Maria Del Pilar Pena

• Foot & Ankle Surgery Podiatrist in Bronx, NY
• Providers in Bronx, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.