Individual provider Active NPI

Alexander Pena, PA-C, ATC

  • Medical Physician Assistant
  • Orange Park, FL
National Provider Identifier
1477937936
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9113666 Issued in FL
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

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251224001340 FL Practitioner - Physician Assistant 4284129420 Reassigns benefits to 1 organization

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
Jacksonville Carenow Urgent Care LLCGroup PAC ID 6800158544, 44 clinicians

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

LicenseStateTypeSpecialty
PA9113666FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avecina Medical PA CurrentSince Nov 20, 2025 Accepting new patients
Jacksonville Carenow Urgent Care, LLC CurrentSince Mar 30, 2026 Accepting new patients
Global Family Care P a CurrentSince Jun 22, 2021 Accepting new patients
Avecina Medical, PA CurrentSince Nov 20, 2025 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.

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

Verify at the official NPI Registry.