Olga Brea Pena, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2018029871 Issued in MO

Practice address

3348 American Ave
Jefferson City, MO 65109-1079

Phone

(573) 761-7210

Fax

(573) 634-8802

NPI assigned

Aug 4, 2015

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: obreapena282653@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• SSM Regional Health Services

  dba SSM Health Medical Group - Pediatrics

  • Clinic/Center
  • Jefferson City, MO
  • NPI 1396782587
  Medicare reassignment NPD
• SSM Regional Health Services

  dba SSM Health Urgent Care

  • Urgent Care Clinic/Center
  • Jefferson City, MO
  • NPI 1831288869
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• SSM Regional Health Services

  dba SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1922119726
  NPD
• SSM Regional Health Services

  dba SSM Health Medical Group - Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson City, MO
  • NPI 1053368159
  NPD (past)
• SSM Regional Health Services

  dba SSM Health St. Mary's Hospital Jefferson City

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  NPD (past)

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1417333253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 DEER VALLEY DRIVE",
            "address_2": "UNIT B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "704-300-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 AMERICAN AVE",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091079",
            "telephone_number": "573-761-7210",
            "fax_number": "573-634-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREA PENA",
        "first_name": "OLGA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018029871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "obreapena282653@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "obreapena282653@direct-ehr-ssmhc.com",
            "address_1": "3348 American Ave",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651091079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3348 American Ave",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651091079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathleen Brandt-Kessler, RN, BSN, LMSW
• Sophie Branson
• Sunchandandeep Singh Brar, MD
• Amber Brasier, LPC
• Joni M Braun, OTR
• Thomas K Bredeman, D.O.
• Rolando Daniel Breier, MD
• Anthony R Brenneke, MPT
• Sandra Brenner, FNP
• Edwin Dean Breshears, M.D.

• Pediatrics Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.