Rebecca Ann Penera, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E5011 Issued in CA

Practice address

18080 Beach Blvd
Suite 102
Huntington Beach, CA 92648-1342

Phone

(714) 841-5055

NPI assigned

Jul 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca Ann Grootegoed-Penera Other name

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• West Coast Foot and Ankle Podiatric Medical Associates Inc

  • Podiatrist
  • Huntington Beach, CA
  • NPI 1356603591
  NPD
• West Coast Foot and Ankle Podiatric Medical Associates Inc

  • Podiatrist
  • Long Beach, CA
  • NPI 1689744666
  NPD
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)
• Talbert Medical Group, P.C.

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1528069176
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  Care Compare affiliation
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Brea, CA
  • NPI 1891904942
  Care Compare affiliation

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1356571715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18080 BEACH BLVD",
            "address_2": "SUITE 102",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481342",
            "telephone_number": "714-841-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18080 BEACH BLVD",
            "address_2": "SUITE 102",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481342",
            "telephone_number": "714-841-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8078 E Santa Ana Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928081108",
            "country_code": "US",
            "telephone_number": "714-974-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2141 N Harbor Blvd Ste 35000",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928353831",
            "country_code": "US",
            "telephone_number": "714-626-8630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055584",
            "country_code": "US",
            "telephone_number": "714-776-3180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENERA",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpenera1373230@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "947 S Anaheim Blvd Ste 125",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928055584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "GROOTEGOED-PENERA",
            "middle_name": "ANN",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorenzo V Pena, PPS
• Melinda Pena
• Yliana Penalosa, NP
• Michelle Pendergast
• Penera Podiatry Corporation
• Peninsula Professional Services
• Stacy Pensinger
• Pauline Pepek, M.D.
• Richard Peprah, M.D.
• Heidi Dawn Peralta, MPT

• Podiatrist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.