Individual provider Active NPI

Jovanna Pena, PA

  • Physician Assistant
  • Edinburg, TX
National Provider Identifier
1902132830
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06299 Issued in TX
Practice address
1517 S McColl Rd
Edinburg, TX 78539-3108
Phone
(956) 381-5300
Fax
(956) 316-4496
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA06299 TX Primary

Addresses

Primary practice location

1517 S McColl Rd
Edinburg, TX 78539-3108

Mailing address

1517 S McColl Rd
Edinburg, TX 78539-3108
Phone (956) 381-5300

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110617000454 TX Practitioner - Physician Assistant 7517145782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

1517 S McColl Rd
Edinburg, TX 78539-3108
Phone (956) 381-5300

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06299TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jul 12, 2021 Accepting new patients

Locations

1517 S McColl Rd
Edinburg, TX 78539
Phone (956) 381-5300

4903 N McColl Rd
McAllen, TX 78504
Phone (956) 631-5864

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: jovanna.penamartinez@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1902132830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393108",
            "telephone_number": "956-381-5300",
            "fax_number": "956-316-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393108",
            "telephone_number": "956-381-5300",
            "fax_number": "956-316-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOVANNA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.