Individual provider Active NPI

Britt Linnea Pena, MD

  • Pediatrics Physician
  • Brockton, MA
National Provider Identifier
1568664795
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M5935 Issued in TX
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

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2148234MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 PediatricsGroup PAC ID 5496807414, 3 clinicians

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

LicenseStateTypeSpecialty
M5935TXMDPediatrics Physician
234537MAMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Pediatrics CurrentSince May 10, 2009 Accepting new patients
Southeast Medical Group, P.C. PastSince May 10, 2009 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

  • Direct secure messaging: pena.britt.brp@direct.partners.masshiway.net
  • FHIR API: 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.

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

Sources for this page

Verify at the official NPI Registry.