Kristin Suzanne Pena, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A75967 Issued in CA

Practice address

138 W Main St
Suite E
Ventura, CA 93001-2584

Phone

(805) 667-2850

Fax

(805) 652-0708

NPI assigned

Dec 15, 2006

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpena3518231@oc.providencedirect.org
• Direct secure messaging: kpena857918@direct.memorialcare.org
• Direct secure messaging: kristin.pena.1@17363.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 and National Provider Directory roles.

• Community Memorial Health System

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1215903018
  Medicare reassignment NPD
• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Family Medicine

  Medicare reassignment NPD
• Primary Medical Group of Ventura County Inc

  • Family Medicine Physician
  • Ventura, CA
  • NPI 1417970849
  Medicare reassignment NPD
• Santa Barbara Neighborhood Clinics

  • Federally Qualified Health Center (FQHC)
  • Isla Vista, CA
  • NPI 1265458434
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Ojai, CA
  • NPI 1588446892
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1861554552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W MAIN ST",
            "address_2": "SUITE E",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012584",
            "telephone_number": "805-667-2850",
            "fax_number": "805-652-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "KRISTIN",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-12-30",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A75967",
            "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": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexis Destiny Pellecer, MD
• Shannon Pelmear, MS
• Susan Pembroke, M.F.T.
• Elizabeth Pena, RBT
• James Paul Pena, M.D.
• Adahli Penaloza
• Penfield Mtu
• Madison Shea Pennington
• Brian Penny, M.D.
• Christine Penrose, RDN, MS

• Family Medicine Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.