Active NPI
Mariasol Pena, M.D.
- Infectious Disease Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- A119968
- Practice address
- 2020 Zonal Ave
Ird 620
Los Angeles, CA 90033 - Phone
- (310) 222-2409
- NPI assigned
- Apr 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | A119968 | CA | Primary |
Addresses
Primary practice location
2020 Zonal Ave
Ird 620
Los Angeles, CA 90033
Mailing address
2020 Zonal Ave
Ird 620
Los Angeles, CA 90033
Phone (323) 226-7504
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Southern California Keck School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 S Raymond Ave
Alhambra, CA 91801-3166
Phone (626) 570-1606
Hospital & facility affiliations
- Pih Health Hospital-Whittier
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A119968 | CA | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telehealth Specialty Medical Group | Infectious Disease | Current | Accepting new patients |
| Mariasol Pena MD | Infectious Disease | Current | Accepting new patients |
| Tele-Medicine Services Ny, PLLC | Past | Accepting new patients |
Locations
100 S Raymond Ave
Alhambra, CA 91801
Phone (626) 457-7938
3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628
Organizations & group practices 3
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.
-
- Infectious Disease Physician
- Los Alamitos, CA
- NPI 1962133207
-
- Emergency Medicine Physician
- Roseville, CA
- NPI 1326338237
Infectious Disease
-
- Internal Medicine Physician
- Roseville, CA
- NPI 1609663780
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Whittier, CA
- NPI 1043215379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1962729673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 ZONAL AVE",
"address_2": "IRD 620",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90033",
"telephone_number": "323-226-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 ZONAL AVE",
"address_2": "IRD 620",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90033",
"telephone_number": "310-222-2409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "MARIASOL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-21",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "CA",
"license": "A119968",
"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": "9400 Rosecrans Ave",
"city": "Bellflower",
"state": "CA",
"country_code": "US",
"postal_code": "907062246",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.