Active NPI
Alexander Pena, PA-C, ATC
- Medical Physician Assistant
- Orange Park, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9113666
- Practice address
- 1677 Wells Rd Ste C
Orange Park, FL 32073-2383 - Phone
- (904) 215-8400
- NPI assigned
- Jul 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9113666 | FL | Primary |
Addresses
Primary practice location
1677 Wells Rd Ste C
Orange Park, FL 32073-2383
Mailing address
4580 Race Track Rd Ste 102
St Johns, FL 32259-2457
Phone (904) 679-3537
Other practice location 1
4580 Race Track Rd Ste 102
St Johns, FL 32259-2457
Phone (904) 679-3537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4580 Race Track Rd
Suite 102
Saint Johns, FL 32259-2457
Phone (904) 679-3537
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9113666 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avecina Medical PA | Current | Accepting new patients | |
| Jacksonville Carenow Urgent Care, LLC | Current | Accepting new patients | |
| Global Family Care P a | Current | Accepting new patients | |
| Avecina Medical, PA | Current | Accepting new patients |
Locations
4815 Sweetgrass Pl
Unit 201
Jacksonville, FL 32224
Phone (904) 367-3372
1633 Race Track Rd
Ste 1
Jacksonville, FL 32259
Phone (904) 230-6988
9580 Applecross Rd
Ste 106
Jacksonville, FL 32222
Phone (904) 778-9180
1677 Wells Rd
Ste C
Orange Park, FL 32073
Phone (904) 215-8400
4580 Race Track Rd
Ste 102
St Johns, FL 32259
Phone (904) 679-3537
1633 Race Track Rd
Ste 101
St Johns, FL 32259
Phone (904) 230-6988
Organizations & group practices 4
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.
-
- Urgent Care Clinic/Center
- Jacksonville, FL
- NPI 1447771670
-
- Urgent Care Clinic/Center
- Jacksonville, FL
- NPI 1215082003
-
- Urgent Care Clinic/Center
- Yulee, FL
- NPI 1962200717
-
- Health Service Clinic/Center
- Orange Park, FL
- NPI 1811193568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770940800000",
"number": "1477937936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4580 RACE TRACK RD STE 102",
"city": "ST JOHNS",
"state": "FL",
"postal_code": "322592457",
"telephone_number": "904-679-3537",
"fax_number": "904-481-8651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1677 WELLS RD STE C",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320732383",
"telephone_number": "904-215-8400"
}
],
"practiceLocations": [
{
"address_1": "4580 Race Track Rd Ste 102",
"address_purpose": "LOCATION",
"city": "St Johns",
"state": "FL",
"postal_code": "322592457",
"country_code": "US",
"telephone_number": "904-679-3537",
"fax_number": "904-481-8651",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENA",
"first_name": "ALEXANDER",
"credential": "PA-C, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-15",
"last_updated": "2026-02-13",
"certification_date": "2026-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9113666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.