Individual provider Active NPI

Robert Mena Jr., PA

  • Physician Assistant
  • Castaic, CA
National Provider Identifier
1730810672
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
28060 Alton Way
Castaic, CA 91384-3804
Phone
(818) 635-5112
NPI assigned
Jun 21, 2022
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

28060 Alton Way
Castaic, CA 91384-3804

Mailing address

28060 Alton Way
Castaic, CA 91384-3804
Phone (818) 635-5112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231129002748 CA Practitioner - Physician Assistant 0143694612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Western University of Health Sciences College of Dental Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13365 W Washington Blvd
Los Angeles, CA 90066-5134
Phone (310) 504-1825

2110 W Sunset Blvd
Suite M
Los Angeles, CA 90026-7318
Phone (833) 873-2852

21835 Ventura Blvd
Suite 21837
Woodland Hills, CA 91364-1838
Phone (818) 600-7348

2944 Tapo Canyon Rd
Suite a
Simi Valley, CA 93063-0903
Phone (805) 306-5990

4550 Van Nuys Blvd
Suite A4
Sherman Oaks, CA 91403-2844
Phone (818) 514-3631

6160 Laurel Canyon Blvd
Suite 160
North Hollywood, CA 91606-3287
Phone (213) 267-6536

620 E Janss Rd
Thousand Oaks, CA 91360-5113
Phone (805) 495-6866

806 New Los Angeles Ave
Moorpark, CA 93021-3608
Phone (805) 334-8650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Nov 10, 2023 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Nov 10, 2023 Accepting new patients
Instant Urgent Care Past Accepting new patients

Locations

6971 El Camino Real
Ste 101
Carlsbad, CA 92009
Phone (760) 258-4971

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

806 New Los Angeles Ave
Moorpark, CA 93021
Phone (805) 334-8650

401 Grand Ave
#1112
Oakland, CA 94610
Phone (800) 756-4206

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

Interoperability endpoints

  • Direct secure messaging: robert.mena.1@11381.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1730810672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28060 ALTON WAY",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843804",
            "telephone_number": "818-635-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28060 ALTON WAY",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913843804",
            "telephone_number": "818-635-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castaic, CA

Sources for this page

Verify at the official NPI Registry.