Individual provider Active NPI

Andres Pena

  • Diagnostic Radiology Physician
  • Erie, PA
National Provider Identifier
1760708259
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD457979 Issued in PA
Practice address
201 State St
Erie, PA 16550-0002
Phone
(814) 877-6182
NPI assigned
Apr 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD457979 PA Primary

Addresses

Primary practice location

201 State St
Erie, PA 16550-0002

Mailing address

333 State St Ste 103
Erie, PA 16507-1450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andres.pena@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160628002376 PA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8729379334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

2060 N Pearl St
Vineyard Primary Care
North East, PA 16428-1926
Phone (814) 877-7711

2500 W 12TH St
Erie, PA 16505-4500
Phone (814) 838-0491

300 State St
Erie, PA 16507-1427
Phone (814) 877-6111

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

  • Upmc Hamot Hospital, Erie, PA, CCN 390063
  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD457979PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Jul 1, 2016 Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

333 State St
Ste 103
Erie, PA 16507

201 State St
Erie, PA 16550
Phone (814) 877-2137

2 Hot Metal St
Ste 1
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: apena197080@upmc.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1760708259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 STATE ST STE 103",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165500002",
            "telephone_number": "814-877-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ANDRES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-09",
        "last_updated": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD457979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andres.pena@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.