Kassandra Nicole Pena-Benavides, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9948TG Issued in TX

Practice address

5702 McPherson Rd Ste 21
Laredo, TX 78041-6884

Phone

(956) 791-5967

NPI assigned

Jun 22, 2020

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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paul Tran OD, PAGroup PAC ID 8820284151, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Paul Tran OD, PA

  • Optometrist
  • Laredo, TX
  • NPI 1205136678
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1881210367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9114 MCPHERSON RD APT 4705",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456652",
            "telephone_number": "956-763-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 MCPHERSON RD STE 21",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416884",
            "telephone_number": "956-791-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA-BENAVIDES",
        "first_name": "KASSANDRA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9948TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana M Pedraza, OTR
• Jorge Alberto Pedraza Jr.
• Mayra A Pedraza
• Carolina Pellum
• Miriam Elisabeth Pelto
• Adriana Elizabeth Pena
• Alexis Lezette Pena
• Diana M. Pena, D.D.S.
• Elizabeth Pena, MS, CF
• Felix Francisco Pena, FNP

• Optometrist in Laredo, TX
• Providers in Laredo, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.
• 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.