Individual provider Active NPI

Joselin Pena

  • Case Manager/Care Coordinator
  • Kissimmee, FL
National Provider Identifier
1508642968
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2490 Seggolia LN
Kissimmee, FL 34741-7962
Phone
(917) 517-4900
NPI assigned
Sep 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

2490 Seggolia LN
Kissimmee, FL 34741-7962

Mailing address

2490 Seggolia LN
Kissimmee, FL 34741-7962
Phone (917) 517-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1508642968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 SEGGOLIA LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417962",
            "telephone_number": "917-517-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 SEGGOLIA LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417962",
            "telephone_number": "917-517-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOSELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.