Individual provider Active NPI

Ariana Marie Pena, MSN, APRN, PNP-PC

  • Pediatric Nurse Practitioner
  • Bay City, TX
National Provider Identifier
1578201349
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1069494 Issued in TX
Practice address
111 Avenue F
Bay City, TX 77414-4117
Phone
(979) 245-2008
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1069494 TX Primary

Addresses

Primary practice location

111 Avenue F
Bay City, TX 77414-4117

Mailing address

111 Avenue F
Bay City, TX 77414-4117
Phone (979) 245-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230921002801 TX Practitioner - Nurse Practitioner 7719331933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1069494TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matagorda Episcopal Health Outreach Program Corporation CurrentSince Jun 23, 2023 Accepting new patients
Matagorda Episcopal Health Outreach Program CurrentSince Jun 23, 2023 Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients
Matagorda Episcopal Health Outreach Program PastSince Aug 25, 2019 Accepting new patients

Locations

111 Avenue F
Bay City, TX 77414
Phone 9792452008300

101 Avenue F N
Bay City, TX 77414

307 Green Ave
Ste A
Palacios, TX 77465
Phone 9792452008300

2112 Regional Medical Dr
Ste 1317
Wharton, TX 77488
Phone 9792452008300

2112 Regional Medical Dr
Ste 1313
Wharton, TX 77488
Phone 9792452008300

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1578201349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 AVENUE F",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774144117",
            "telephone_number": "979-245-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 AVENUE F",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774144117",
            "telephone_number": "979-245-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ARIANA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, PNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1069494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, TX

Sources for this page

Verify at the official NPI Registry.