Jonathan Dell Pangelinan Pena, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A146279 Issued in CA

Practice address

60 MDG/Sgoe
101 Bodin Circle
Travis AFB, CA 94535-1800

Phone

(707) 423-3825

NPI assigned

Apr 19, 2016

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 CA

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital, Riverside Hospital, Riverside, CA, CCN 050686

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Emergency Medicine

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Newport Emergency Medical Group Inc

  • Medical Specialty Clinic/Center
  • Newport Beach, CA
  • NPI 1922061779
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Emergency Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hemet, CA
  • NPI 1013433465
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD
• NH Camp Pendleton

  • Military General Acute Care Hospital
  • Camp Pendleton, CA
  • NPI 1386604387
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital, Riverside

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1306991211
  Care Compare affiliation

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1821442609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MDG/SGOE",
            "address_2": "101 BODIN CIRCLE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351800",
            "telephone_number": "707-423-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MDG/SGOE",
            "address_2": "101 BODIN CIRCLE",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351800",
            "telephone_number": "707-423-3825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Dr S",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-5239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Mercy Circle",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "92058",
            "country_code": "US",
            "telephone_number": "760-725-1288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA",
        "first_name": "JONATHAN DELL",
        "middle_name": "PANGELINAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2023-01-19",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A146279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Lynn Patton
• Kristina Allison Paulantonio, MD
• Lee Edward Payne, M.D.
• Ryan Pearson, MD
• Anita V. Pechenenko, M.D.
• Danielle Nicole Pender, PHARMD
• David Lee Perkins, CRNA
• Henry Perlman, PT, DPT
• Jeffery Perry, RD
• Marie Chola Perucho

• Emergency Medicine Physician in Travis AFB, CA
• Providers in Travis AFB, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.
• 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.