NICHOLAS JOSEPH PENA PA-C
NPI 1083176077
Physician Assistant in Ontario, CA

Q: What is Nicholas Pena's NPI number?

The NPI number for Nicholas Pena is 1083176077. It was assigned to this individual provider in the NPPES registry on April 1, 2019.

Q: What is Nicholas Pena's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Pena was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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 April 01, 2019PECOS EnrolledAccepts Medicare Assignment

2295 S VINEYARD AVE, ONTARIO, CA 91761(888) 750-0036 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2025, May 6, 2024, Apr 7, 2024 and 6 more (9 updates tracked since 2019).

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About Nicholas Joseph Pena Pa-c NPPES

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

NICHOLAS JOSEPH PENA PA-C (NPI 1083176077) is an individual physician assistant in Ontario, California, licensed in California (56636) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Legacy Mount Hood Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1083176077

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameNICHOLAS JOSEPH PENACredential: PA-C

Location Address2295 S VINEYARD AVEOntario, CA 91761-7925

Mailing Address385 S Manchester Ave, Unit 2109Orange, CA 92868-3250 · (562) 787-2940

Phone(888) 750-0036

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateApril 1, 2019

Last NPPES UpdateMarch 7, 20259 updates tracked since enumeration

NPPES CertifiedMarch 7, 2025

✔ NPI 1083176077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in CA · 56636✔ Licensed in WA · PA61575377

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2295 S VINEYARD AVE, Ontario, CA 91761

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Secondary Practice Locations 2

Location 12501 E Chapman Ave Ste 101Orange, CA 92869-3204 · Phone (714) 628-3300

Location 22850 SE Powell Valley RdGresham, OR 97080-1494 · Phone (503) 666-5050

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.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

Nicholas Joseph Pena Pa-c 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 ID244567451

PECOS Enrollment IDI20190812001173, I20250626003132

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.

Areas of Expertise CMS Part B claims 3

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.

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.

76 services75 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.

34 services34 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Legacy Mount Hood Medical Center

Acute Care Hospitals · Gresham, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380025

Location24800 SE Stark StreetGresham, OR 97030 · Multnomah County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91761 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

Most-billed visit code 99213

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

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Other Providers at the Same Location NPPES 20

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

DR. BENJAMIN MAURICE KERSHBERG M.D.

Pediatrics

2295 S VINEYARD AVE, MOB A
ONTARIO, CA 91761

San Bernardino County (909) 724-2554

MS. CHRISTINE RAMOS PHARM.D.

Pharmacist