Marilyn Pena

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP 9288272 Issued in FL

Practice address

4506 N Armenia Ave
2901 W. St. Isabel St. Ste # D
Tampa, FL 33603-2732

Phone

(813) 879-3530

Fax

(813) 874-6608

NPI assigned

May 11, 2016

Last updated

Jun 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marilyn.pena.1@29833.direct.athenahealth.com

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.

• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Nurse Practitioner

  Medicare reassignment NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD
• Julio J Valdes, M.D.,PA

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1598035669
  NPD (past)
• Marilyn Simeon Pena

  • Pediatric Nurse Practitioner
  • Tampa, FL
  • NPI 1578924353
  NPD (past)

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1790131589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4506 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032732",
            "telephone_number": "813-879-3530",
            "fax_number": "813-874-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 N ARMENIA AVE",
            "address_2": "2901 W. ST. ISABEL ST. STE # D",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032732",
            "telephone_number": "813-879-3530",
            "fax_number": "813-874-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "MARILYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9288272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1578924353",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elyssa Emily Pena, B.A
• Julio Cesar Pena, MD
• Leonardo Pena, M.D.
• Leslie Melissa Pena
• Luis Roberto Pena, MD
• Martha Pena, ARNP
• Mauricio L Pena
• Reshelle Deanne Pena, M.D.
• Jose Penagaricano, MD
• Vanessa Penalbert

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.

Verify at the official NPI Registry.