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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

NICOLAS R DELAPENA M.D.
NPI 1043204605
Internal Medicine - Infectious Disease in Merced, CA

Active since September 09, 2005PECOS EnrolledCLIA 05D0984823 · Waiver
19.44/100
CMS Quality Rating
3389 G ST, SUITE A, MERCED, CA 95340(209) 722-1205(209) 722-7833 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Nicolas R Delapena M.d. NPPES

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

NICOLAS R DELAPENA M.D. (NPI 1043204605) is an individual infectious disease provider in Merced, California, licensed in California (A61619) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through March 29, 2027, and is a graduate of Saint Louis University School Of Medicine (1986).

NPPES Registry Identity

NPI1043204605
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameNICOLAS R DELAPENACredential: M.D.
Location Address3389 G ST, SUITE AMerced, CA 95340-0964
Mailing Address3389 G St, Suite AMerced, CA 95340-0964 · (209) 722-1205 · Fax (209) 722-7833
Phone(209) 722-1205
Fax(209) 722-7833
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1986
Enumeration DateSeptember 9, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1043204605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in CA · A61619
Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

3389 G ST, Merced, CA 95340
Open in Google Maps ↗

Other Identifiers 1

Medicaid00A616191CA

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

Nicolas R Delapena M.d. 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 ID1557316254
PECOS Enrollment IDI20050315001080
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0984823

Nicolas R Dela Pena MD · Merced, CA
Active · expires Mar 29, 2027
CLIA Number05D0984823
Laboratory TypePhysician Office
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorNicolas R. Dela Pena
Laboratory Phone(209) 722-1205
Laboratory LocationNicolas R Dela Pena MD3389 G Street, Ste A, Merced, CA 95340
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
1,454 services251 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,406 services331 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
294 services259 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
190 services143 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
50 services11 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
40 services33 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95340 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
$133.94 typical visit price
range $58.87 – $176.60
Typical copayment $33.48 (range $14.71 – $44.15)
Most-billed visit code 99204
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

19.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost64.81

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
5%176 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 15

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

Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233
DME-Other DME · category DE017N
2 suppliers12 claims24 services$0.44 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
21 suppliers158 claims361 services$6.23 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
4 suppliers37 claims37 services$2.95 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
4 suppliers14 claims14 services$1.85 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
17 suppliers79 claims128 services$1.15 avg. paid by Medicare
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims360 services$3.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

NICOLAS DE LA PENA MD INC
Clinic/Center (Health Service)
3389 G ST, SUITE A
MERCED, CA 95340
Merced County (209) 722-1205
MRS. RUBIROSA CERVANTES ARANDIA
Nurse Practitioner (Family)
3389 G ST
MERCED, CA 95340
Merced County (209) 384-9401
SUNIT R PATEL MD A PROFESSIONAL CORPORATION
Specialist
3389 G ST, SUITE B
MERCED, CA 95340
Merced County (209) 384-9400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicolas Delapena's NPI number?

The NPI number for Nicolas Delapena is 1043204605. It was assigned to this individual provider in the NPPES registry on September 9, 2005.

Where is Nicolas Delapena located?

Nicolas Delapena practices at 3389 G St Suite A, Merced, CA 95340. The listed phone number is (209) 722-1205.

What is Nicolas Delapena's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Nicolas Delapena enrolled in Medicare?

Yes. Nicolas Delapena is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Nicolas Delapena hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0984823) is associated with this NPI, valid through March 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Nicolas Delapena was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.