Juan Pablo Penaloza, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

262670 Issued in NY

Practice address

1276 Fulton Ave
Bronx, NY 10456-3402

Phone

(718) 901-8484

Fax

(718) 901-8656

NPI assigned

May 20, 2008

Sex

Male

Sole proprietor

No

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

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center Psychiatry Provider Group

  • Psychiatry Physician
  • Paramus, NJ
  • NPI 1578641924
  Medicare reassignment Care Compare group NPD
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855

  Psychiatry

  Medicare reassignment NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD
• Bronxcare Health System

  • Psychiatry Physician
  • Bronx, NY
  • NPI 1073806519
  NPD (past)
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1689682999
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1689682999
  Care Compare affiliation

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1730346453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8484",
            "fax_number": "718-901-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8484",
            "fax_number": "718-901-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENALOZA",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "262670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wandaly Pena
• Yojarda Pena
• Ysalia Lidorca Pena, LMSW
• Yudelka Pena, LMSW
• Pena's Excellent Transportation LLC
• Ingrid Penate, MD
• Erin Pendergist
• Angel Yuqing Peng, M.D.
• Jiahao Peng, MD PHD
• Lilly Hong Peng

• Psychiatry Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.

Verify at the official NPI Registry.