Individual provider Active NPI

Eneysis Margarita Pena, MD

  • Neonatal-Perinatal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1770752701
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01093339A Issued in IN
Practice address
8081 Township Line Rd Ste 203
Indianapolis, IN 46260-2189
Phone
(317) 415-8100
NPI assigned
Feb 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 35.085953 OH
Neonatal-Perinatal Medicine Physician 2080N0001X 01093339A IN Primary

Addresses

Primary practice location

8081 Township Line Rd Ste 203
Indianapolis, IN 46260-2189

Mailing address

8081 Township Line Rd Ste 203
Indianapolis, IN 46260-2189

Other practice location 1

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 2

8111 Township Line Rd
Indianapolis, IN 46260-2479
Phone (317) 415-7921

Other identifiers 1

IdentifierTypeStateIssuer
2961871MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, AZ, IN3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20091022000143 OH Practitioner - Pediatric Medicine 1759456205 Reassigns benefits to 1 organization
I20240626002992 AZ Practitioner - Pediatric Medicine 1759456205 Reassigns benefits to 1 organization
I20240815002861 IN Practitioner - Pediatric Medicine 1759456205 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.085953OHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Sep 9, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Jun 1, 2024 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Sep 9, 2024 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

8081 Township Line Rd
Ste 203
Indianapolis, IN 46260
Phone (317) 415-7921

8111 Township Line Rd
Indianapolis, IN 46260
Phone (317) 415-7921

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1203811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1770752701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 TOWNSHIP LINE RD STE 203",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 TOWNSHIP LINE RD STE 203",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602189",
            "telephone_number": "317-415-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-4541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8111 Township Line Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462602479",
            "country_code": "US",
            "telephone_number": "317-415-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "ENEYSIS",
        "middle_name": "MARGARITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-24",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "35.085953",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01093339A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2961871",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.