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MARGARITA PENA MD
NPI 1104871565
Emergency Medicine in Southfield, MI

Active since May 24, 2006PECOS EnrolledAccepts Medicare Assignment
18161 W 13 MILE RD, SUITE A-2, SOUTHFIELD, MI 48076(248) 642-9893 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Margarita Pena Md NPPES

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

MARGARITA PENA MD (NPI 1104871565) is an individual emergency medicine provider in Southfield, Michigan, licensed in Michigan (4301057743) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Ascension St John Hospital, and is a graduate of Illinois Medical College (1991).

NPPES Registry Identity

NPI1104871565
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameMARGARITA PENACredential: MD
Location Address18161 W 13 MILE RD, SUITE A-2Southfield, MI 48076-1113
Mailing Address18161 W 13 Mile Rd, Suite A-2Southfield, MI 48076-1113 · (248) 642-9893
Phone(248) 642-9893
Sole ProprietorNo
Medical School CMSIllinois Medical CollegeGraduated 1991
Enumeration DateMay 24, 2006
Last NPPES UpdateOctober 27, 2025
NPPES CertifiedOctober 27, 2025
✔ NPI 1104871565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MI · 4301057743
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 4301057743 (MI)
18161 W 13 MILE RD, Southfield, MI 48076
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Margarita 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 ID7618866989
PECOS Enrollment IDI20040313000678
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 6

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.

Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
52 services51 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
44 services43 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
31 services31 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.
24 services24 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
15 services15 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230165
Location22101 Moross RdDetroit, MI 48236 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48076 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

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…
86%81 patients4/55-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.

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.

TOTAL RECOVERY PHYSICAL THERAPY LLC
Specialist
18161 W 13 MILE RD, SUITE E 3
SOUTHFIELD, MI 48076
Oakland County (248) 792-3338
DR. WISSAM ALAWIEH PHARM.D.
Pharmacist
18161 W 13 MILE RD, A1
SOUTHFIELD, MI 48076
Oakland County (248) 419-1776
MICHIGAN COLON & RECTAL SURGEONS, PC
Colon & Rectal Surgery
18161 W 13 MILE RD, SUITE A1
SOUTHFIELD, MI 48076
Oakland County (248) 644-3711
PAUL SCHWARZ PA
Physician Assistant
18161 W 13 MILE RD, SUITE A-2
SOUTHFIELD, MI 48076
Oakland County (248) 642-9893
RAYMOND RUDONI MD
Emergency Medicine
18161 W 13 MILE RD, SUITE A-2
SOUTHFIELD, MI 48076
Oakland County (248) 642-9893
DR. LORI SUE DUNCAN DPM
Podiatrist
18161 W 13 MILE RD, #D2
SOUTHFIELD, MI 48076
Oakland County (248) 258-0001
DAVIN REHAB SERVICES.INC
Physical Therapist
18161 W 13 MILE RD, SUIT A-2
SOUTHFIELD, MI 48076
Oakland County (248) 819-6413
DR. DATHATREYA KANDAGARI
Physical Therapist
18161 W 13 MILE RD, SUITE E-3
SOUTHFIELD, MI 48076
Oakland County (248) 644-6272

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 Margarita Pena's NPI number?

The NPI number for Margarita Pena is 1104871565. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Where is Margarita Pena located?

Margarita Pena practices at 18161 W 13 Mile Rd Suite A-2, Southfield, MI 48076. The listed phone number is (248) 642-9893.

What is Margarita Pena's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Margarita Pena enrolled in Medicare?

Yes. Margarita 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.

What insurance does Margarita Pena accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Margarita 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.

Is Margarita Pena affiliated with any hospitals?

According to CMS data, Margarita Pena is affiliated with Ascension St John Hospital.

When was this NPI record last updated?

The NPPES record for Margarita Pena was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.