DR. RAUL ADRIAN PENA MD
NPI 1164456943
Ophthalmology in Mcallen, TX
About Dr. Raul Adrian Pena Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RAUL ADRIAN PENA MD (NPI 1164456943) is an individual ophthalmology provider in Mcallen, Texas, licensed in Texas (L0504) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Doctors Hosptal At Renaissance, and is a graduate of Other (1988).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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
Dr. Raul Adrian 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.
Medicare Billing Reassignment
Medicare enrollment records show Raul Pena reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mcallen, TX 78503
- Reassigned Medicare billing, Texas enrollment
- 4 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.
Areas of Expertise CMS Part B claims 10
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 Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Doctors Hosptal At Renaissance
Acute Care Hospitals · Edinburg, TXPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 78503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Raul Pena's NPI number?
The NPI number for Raul Pena is 1164456943. It was assigned to this individual provider in the NPPES registry on July 10, 2006.
Where is Raul Pena located?
Raul Pena practices at 1400 E Ridge Rd Ste 10, Mcallen, TX 78503. The listed phone number is (956) 661-8733.
What is Raul Pena's specialty?
The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.
Is Raul Pena enrolled in Medicare?
Yes. Raul 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 Raul Pena's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Raul Pena reassigns Medicare benefits to Raul Adrian Pena MD PA (Mcallen, TX). 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 Raul Pena's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Raul Pena accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 9 other insurers list Raul 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 Raul Pena affiliated with any hospitals?
According to CMS data, Raul Pena is affiliated with Doctors Hosptal At Renaissance.
When was this NPI record last updated?
The NPPES record for Raul Pena was last updated on May 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. Raul Adrian Pena, MD · NPI 1164456943
Ophthalmology physician in Mcallen, Texas. Individual provider, active in the CMS NPPES registry since July 10, 2006.
## Identity
- **NPI:** 1164456943 (Entity type: Individual)
- **Enumerated:** July 10, 2006
- **Primary specialty:** Ophthalmology · taxonomy 207W00000X
- **State license:** L0504 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1400 E RIDGE RD STE 10, Mcallen, TX 78503-1536
- **Phone:** (956) 661-8733 · **Fax:** (956) 661-8724
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Raul Adrian Pena MD PA (NPI 1407037633, Mcallen, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1988
## Record status
- **NPPES last updated:** May 5, 2020
- **Other identifiers:** Other L0504 (TX)
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Source: [NPI Profile](https://npiprofile.com/npi/1164456943) · Data from the CMS NPPES public registry.