Alejandro Raciel Pena Pupo

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3468 E Sahara Ave Ste 165
Las Vegas, NV 89104-4827

Phone

(702) 207-0842

NPI assigned

Sep 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1861006272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 E SAHARA AVE STE 165",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044827",
            "telephone_number": "702-207-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 E SAHARA AVE STE 165",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891044827",
            "telephone_number": "702-207-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA PUPO",
        "first_name": "ALEJANDRO",
        "middle_name": "RACIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Pena Katkova
• Gladys Beatriz Pena Lara
• Serina Pena Martinez
• Yris Pena Melo
• Yamilet Ramona Pena Pena
• David M Pena Sariol, CMT
• Leeyana Angelica Pena-Dannenbring, LSW
• Adriana Pena
• Agustin Pena
• Arianna Alejandrina Pena

• Community Health Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Health Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.