John Lee Pena, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1291049 Issued in TX

Practice address

709 N FM 1187 Ste 500
Aledo, TX 76008-4338

Phone

(817) 366-5754

NPI assigned

Feb 25, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of North Texas HSC, College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physiologic, LLCGroup PAC ID 5597152090, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26216/brand/1/csg/1/fhir/r4

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.

• Physiologic, LLC

  • Physical Therapist
  • Aledo, TX
  • NPI 1538815576
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1790431989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 FIR TREE LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761235027",
            "telephone_number": "817-366-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N FM 1187 STE 500",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760084338",
            "telephone_number": "817-366-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOHN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1291049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PhysioLogicTX.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "709 N Fm 1187 Ste 500",
            "city": "Aledo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760084338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cheryl Oswalt, LCSW
• Keena Pace, LCSW
• Michelle Parker, D.C.
• Lauren Elizabeth Pate, PT, DPT
• Kaley Lauren Pelfrey, MSAT, ATC, LAT
• Amanda M Pendleton, AUD, CCC-A
• Jordana Simone Pepper, PH.D
• Matthew Abraham Phares, D.O.
• Physiologic, LLC
• Laura G Power, M.D.

• Physical Therapist in Aledo, TX
• Providers in Aledo, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.