Julene Tina Pena, O.D., F.A.A.O.

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

TA2029 Issued in MD

Practice address

6200 Baltimore Avene
Suite 100
Riverdale, MD 20737

Phone

(240) 737-5160

NPI assigned

Apr 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Columbia Lighthouse for the Blind

  • Optometrist
  • Silver Spring, MD
  • NPI 1043458870
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649392754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 11TH ST NW APT 201",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200014317",
            "telephone_number": "240-737-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 BALTIMORE AVENE",
            "address_2": "SUITE 100",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "20737",
            "telephone_number": "240-737-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JULENE",
        "middle_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "O.D., F.A.A.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "MD",
            "license": "TA2029",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "12343T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelagie Pani
• Joan Parambi, M.D.
• Eunhyae Park, DDS
• Sarah Kilsoon Park, DDS
• Patient Care Jobfinders (Patient Care Services)
• Sammir Perez Sanjuanelo, MD
• Gail Ann Petersen, O.D.
• PG County Endoscopy Center LLC
• Mariana Polanco Alvarez
• Jeri Price

• Low Vision Rehabilitation Optometrist in Riverdale, MD
• Providers in Riverdale, MD by specialty
• Low Vision Rehabilitation Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.