Active NPI
Britt Linnea Pena, MD
- Pediatrics Physician
- Brockton, MA
National Provider Identifier
1568664795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- M5935
- Practice address
- 65 Libby St
Brockton, MA 02302-2949 - Phone
- (508) 584-6060
- Fax
- (508) 584-4949
- NPI assigned
- Jun 1, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M5935 | TX | Primary |
Addresses
Primary practice location
65 Libby St
Brockton, MA 02302-2949
Mailing address
65 Libby St
Brockton, MA 02302-2949
Phone (508) 584-6060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2148234 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080325000229 | MA | Practitioner - Pediatric Medicine | 0143320622 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Tufts University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brockton Pediatrics
Practice addresses (Care Compare)
65 Libby St
Brockton, MA 02302-2949
Phone (508) 584-6060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5935 | TX | MD | Pediatrics Physician |
| 234537 | MA | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brockton Pediatrics | Current | Accepting new patients | |
| Southeast Medical Group, P.C. | Past | Accepting new patients |
Locations
65 Libby St
Brockton, MA 02302
Phone (508) 584-6060
36 N Bedford St
East Bridgewater, MA 02333
Phone (508) 378-1280
Interoperability endpoints
- pena.britt.brp@direct.partners.masshiway.net
- https://fhir4.healow.com/fhir/r4/DIJIBA
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Alpharetta, GA
- NPI 1235296054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1568664795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 LIBBY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022949",
"telephone_number": "508-584-6060",
"fax_number": "508-584-4949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 LIBBY ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022949",
"telephone_number": "508-584-6060",
"fax_number": "508-584-4949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "BRITT",
"middle_name": "LINNEA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-01",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "M5935",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2148234",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
- Kathleen Peck, MSW,LICSW
- Pediatric Associates Inc. of Brockton
- Pediatric Services of America, LLC
- Kerri Ellen Pelton, LCSW
- Victoria Amelia Pena Objio
- Miguel Angel Pena, MD
- Rachel Pena
- People'S Best Care Chiropractic & Rehabilitation Inc.
- People'S Best Care Chiropractic and Rehab Plus
- Laura Teresa Peralta
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.