Michael R Pena, M.D. PHD
Individual provider Active NPI Family Medicine Physician · Lovington, NM
NPI 1366732604 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1366732604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD2017-0882 (NM)
- Practice address
- 1600 N Main Ave
Lovington, NM 88260-2830 - Phone
- (575) 396-6611
- Fax
- (575) 396-4547
- NPI assigned
- Apr 7, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ess Hospitalist LLC
Nor-Lea Hospital District
Emergency Staffing Solutions Inc
Practice addresses (Care Compare)
1313 E 32ND St
Silver City, NM 88061-7251
Phone (575) 538-4000
1600 N Main
Lovington, NM 88260-2813
1600 N Main Ave
Lovington, NM 88260-2813
Phone 57539666115303
515 E Main St
Hobbs, NM 88240-8119
Phone (575) 397-0560
800 E 9TH Ave
Truth Or Consequences, NM 87901-1954
Phone (575) 894-2111
Hospital & facility affiliations
- Nor-Lea Hospital District
- Sierra Vista Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171208000608 | NM | Practitioner - Family Practice | 2668643560 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2017-0882 | NM | MD | Family Medicine Physician |
| MD443240 | PA | MD | Family Medicine Physician |
| 8607 | SD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nor-Lea Hospital District | Current |
Accepting new patients | |
| Emergency Staffing Solutions Inc | Current |
Accepting new patients | |
| Ess Hospitalist LLC | Current |
Accepting new patients | |
| Nor-Lea Hospital District | Current |
Accepting new patients | |
| Sierra Vista Hospital | Current |
Accepting new patients | |
| Sierra Vista Hospital | Past | Accepting new patients |
Locations
515 E Main St
Hobbs, NM 88240
Phone (575) 397-0560
1600 N Main Ave
Lovington, NM 88260
Phone (575) 396-6611
1313 E 32nd St
Silver City, NM 88061
Phone (505) 537-4953
800 E 9th Ave
Truth Or Consequences, NM 87901
Phone (505) 743-1270
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26460 | NE | |
| Family Medicine Physician | 207Q00000X | 8607 | SD | |
| Family Medicine Physician | 207Q00000X | MD443240 | PA | |
| Family Medicine Physician | 207Q00000X | MD2017-0882 | NM | Yes |
Addresses
Primary practice location
1600 N Main Ave
Lovington, NM 88260-2830
Mailing address
1600 N Main Ave
Lovington, NM 88260-2830
Phone (575) 396-6611
Other practice location 1
300 S Byron Blvd
Chamberlain, SD 57325-9741
Phone (605) 234-6551
Other practice location 2
300 S Byron Blvd
Chamberlain, SD 57325-9741
Phone (605) 234-6551
Other providers in Lovington, NM
- Alejandra Parra
- Azucena M Parra
- Rocio Parra
- Kelly Lee Parson
- Nancy N Peacock
- Brenda D'Ann Perry
- Candy L Peters
- Cheryle Lynne Phelan
- Rhonda K. Phillips
- Prafulla Pochampally
All providers in Lovington, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.