Ruben R Pena, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601002738 Issued in MI

Practice address

10652 S Eastern Ave
Suite a
Henderson, NV 89052-4952

Phone

(702) 476-2800

Fax

(702) 476-2040

NPI assigned

Mar 7, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Lansing Urgent Care, PLC

  • Urgent Care Clinic/Center
  • Lansing, MI
  • NPI 1780987990
  NPD (past)
• Quality Care Physicians Group

  • Emergency Medicine Physician
  • Waterford, MI
  • NPI 1114974912

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1457481517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743752",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743752",
            "telephone_number": "702-476-2800",
            "fax_number": "702-476-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10652 S EASTERN AVE",
            "address_2": "SUITE A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524952",
            "telephone_number": "702-476-2800",
            "fax_number": "702-476-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "RUBEN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Pelletier
• Lauren Whitney Pelletier, LSW
• Gabriela N. Pena, MD
• Kayla Pena, LMSW, CSW INTERN
• Miguel Pena
• Michelle Penaloza Heredia
• Julian Penaranda, DPT
• Devin William Pendergast
• Daniel Leo Pendleton, MD
• Adrionna Penha

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.