GUILLERMO A PENA MD
NPI 1013978162
Internal Medicine in Blue Ridge, GA

Q: What is Guillermo Pena's NPI number?

The NPI number for Guillermo Pena is 1013978162. It was assigned to this individual provider in the NPPES registry on March 29, 2006.

Q: What is Guillermo Pena's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Guillermo Pena was last updated on November 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2006PECOS EnrolledAccepts Medicare Assignment

165 BLUE RIDGE OVERLOOK, BLUE RIDGE, GA 30513(706) 946-4647(706) 374-5006 Get Directions Write a Review

NPPES record last updated: November 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2021, Jul 20, 2020, Apr 25, 2017 (3 updates tracked since 2017).

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About Guillermo A Pena Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GUILLERMO A PENA MD (NPI 1013978162) is an individual internal medicine provider in Blue Ridge, Georgia, licensed in Georgia (059493) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1013978162

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameGUILLERMO A PENACredential: MD

Location Address165 BLUE RIDGE OVERLOOKBlue Ridge, GA 30513-4431

Mailing Address165 Blue Ridge OverlookBlue Ridge, GA 30513-4431 · (706) 946-5608 · Fax (706) 374-7628

Phone(706) 946-4647

Fax(706) 374-5006

Sole ProprietorNo

Medical School CMSOtherGraduated 1982

Enumeration DateMarch 29, 2006

Last NPPES UpdateNovember 4, 20213 updates tracked since enumeration

NPPES CertifiedNovember 4, 2021

✔ NPI 1013978162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in GA · 059493✔ Licensed in FL · 46222

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

165 BLUE RIDGE OVERLOOK, Blue Ridge, GA 30513

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Other Identifiers 2

Medicaid040614700FL

Medicaid297695058AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Guillermo A Pena Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486663739

PECOS Enrollment IDI20140218001375

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number110029

Location743 Spring StreetGainesville, GA 30501 · Hall County

Emergency services Birthing friendly

Union General Hospital

Acute Care Hospitals · Blairsville, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110051

Location35 Hospital RoadBlairsville, GA 30512 · Union County

Emergency services Birthing friendly

Piedmont Mountainside Hospital Inc

Acute Care Hospitals · Jasper, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110225

Location1266 Highway 515 SouthJasper, GA 30143 · Pickens County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30513 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers22 claims68 services$5.55 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers13 claims68 services$3.18 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

2 suppliers15 claims16 services$15.42 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers23 claims24 services$50.17 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers18 claims18 services$87.82 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIETTE P LANGNER MD

Family Medicine