Cleofas Pena, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05330 Issued in TX

Practice address

1713 Treasure Hills Blvd Ste 1B
Harlingen, TX 78550-8913

Phone

(956) 425-9240

Fax

(956) 412-8575

NPI assigned

Jul 9, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• William R McKenna MD PA

  • Allergy Physician
  • Harlingen, TX
  • NPI 1386766681
  Medicare reassignment

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285863381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 TREASURE HILLS BLVD STE 1B",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508913",
            "telephone_number": "956-425-9240",
            "fax_number": "956-412-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 TREASURE HILLS BLVD STE 1B",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508913",
            "telephone_number": "956-425-9240",
            "fax_number": "956-412-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "CLEOFAS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PERMIT",
            "identifier": "PA05330",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "V0154186",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minerva Pedraza, LVN
• Pedro Manuel Yzaguirre
• Pegasus Quest, L.L.C.
• Lisa Diane Pelache
• Alberto Pena, MD
• Eduardo Javier Pena, LVN
• Janet Darling Pena, LVN
• Johanna Garcia Pena
• Jose Adan Pena
• Kristal Pena, SLP

• Physician Assistant in Harlingen, TX
• Providers in Harlingen, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.