JACQUELINE PENA
NPI 1073163564
Counselor - Professional in Minneapolis, MN
About Jacqueline Pena NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACQUELINE PENA (NPI 1073163564) is an individual professional provider in Minneapolis, Minnesota, licensed in Minnesota (4397) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jacqueline Pena 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.
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Pena reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New Brighton, MN 55112
- Reassigned Medicare billing, Minnesota enrollment
- 794 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
MINNEAPOLIS, MN 55410
MINNEAPOLIS, MN 55410
MINNEAPOLIS, MN 55410
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 Jacqueline Pena's NPI number?
The NPI number for Jacqueline Pena is 1073163564. It was assigned to this individual provider in the NPPES registry on September 17, 2019.
Where is Jacqueline Pena located?
Jacqueline Pena practices at 3801 W 50th St Ste 250B, Minneapolis, MN 55410. The listed phone number is (612) 400-9685.
What is Jacqueline Pena's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jacqueline Pena enrolled in Medicare?
Yes. Jacqueline Pena 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.
Which organization bills Medicare for Jacqueline Pena's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Pena reassigns Medicare benefits to Nystrom & Associates, Ltd (New Brighton, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Pena's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jacqueline Pena accept?
Health plans from Blue Cross and Blue Shield of Texas and Sanford Health Plan list Jacqueline Pena as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacqueline Pena was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jacqueline Pena · NPI 1073163564
Professional provider in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since September 17, 2019.
## Identity
- **NPI:** 1073163564 (Entity type: Individual)
- **Enumerated:** September 17, 2019
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 4397 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 3801 W 50TH ST STE 250B, Minneapolis, MN 55410-2070
- **Phone:** (612) 400-9685
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Nystrom & Associates, Ltd (NPI 1396750188, New Brighton, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** May 30, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1073163564) · Data from the CMS NPPES public registry.