Active NPI
Yolanda M Pena, MD
- Neurology Physician
- Avon, CT
National Provider Identifier
1659348365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 023674
- Practice address
- 40 Dale Rd
Ste 104
Avon, CT 06001-3692 - Phone
- (860) 676-8115
- Fax
- (860) 677-6015
- NPI assigned
- Mar 1, 2006
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 023674 | CT | Primary |
Addresses
Primary practice location
40 Dale Rd
Ste 104
Avon, CT 06001-3692
Mailing address
40 Dale Rd
Suite 200
Avon, CT 06001-3692
Phone (860) 676-8115
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0V0022 | Other | CT | HEALTHNET |
| 001236744 | Medicaid | CT | |
| 010023674CT02 | Other | CT | ANTHEM BCBS |
Other names 1
- Yolanda M Pena-Walzak
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20120124000647 | CT | Practitioner - Neurology | 8921275496 | Practice locations: Avon, CT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023674 | CT | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1659348365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 DALE RD",
"address_2": "SUITE 200",
"city": "AVON",
"state": "CT",
"postal_code": "060013692",
"telephone_number": "860-676-8115",
"fax_number": "860-677-6015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 DALE RD",
"address_2": "STE 104",
"city": "AVON",
"state": "CT",
"postal_code": "060013692",
"telephone_number": "860-676-8115",
"fax_number": "860-677-6015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "YOLANDA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CT",
"license": "023674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "0V0022",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001236744",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "010023674CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "YOLANDA",
"last_name": "PENA-WALZAK",
"middle_name": "M",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.