DR. RAUL ADRIAN PENA MD
NPI 1164456943
Ophthalmology in Mcallen, TX

Q: 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.

Q: What is Raul Pena's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: 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.

Active since July 10, 2006PECOS EnrolledAccepts Medicare Assignment

88.33/100

CMS Quality Rating

1400 E RIDGE RD STE 10, MCALLEN, TX 78503(956) 661-8733(956) 661-8724 Get Directions Write a Review

NPPES record last updated: May 5, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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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

NPI1164456943

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. RAUL ADRIAN PENACredential: MD

Location Address1400 E RIDGE RD STE 10Mcallen, TX 78503-1536

Mailing Address1400 E Ridge Rd Ste 10Mcallen, TX 78503-1536 · (956) 661-8733 · Fax (956) 661-8724

Phone(956) 661-8733

Fax(956) 661-8724

Sole ProprietorYes

Medical School CMSOtherGraduated 1988

Enumeration DateJuly 10, 2006

Last NPPES UpdateMay 5, 2020

NPPES CertifiedMay 5, 2020

✔ NPI 1164456943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in TX · L0504

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1400 E RIDGE RD STE 10, Mcallen, TX 78503

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Other Identifiers 1

OtherL0504TX · Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

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.

PECOS PAC ID1951369123

PECOS Enrollment IDI20041221000207

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 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.

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

205 services115 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

148 services123 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

135 services80 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

133 services91 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

62 services62 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

56 services56 patients

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, TX

3/5 CMS rating

OwnershipPhysician

CMS Certification Number450869

Location5501 South MccollEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Physician 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.

New Patient

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

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.

88.33/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

49.41

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

99%211 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 5

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

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