CARLOS J PENA PA-C
NPI 1245687052
Physician Assistant in Sacramento, CA

Active since May 21, 2016PECOS EnrolledAccepts Medicare Assignment
94.62/100
CMS Quality Rating
4301 X ST, SACRAMENTO, CA 95817(916) 734-2011 Get Directions Write a Review

NPPES record last updated: February 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 24, 2025, Aug 18, 2016, May 21, 2016 (3 updates tracked since 2016).

About Carlos J Pena Pa-c NPPES

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

CARLOS J PENA PA-C (NPI 1245687052) is an individual physician assistant in Sacramento, California, licensed in California (PA53458) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1245687052
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameCARLOS J PENACredential: PA-C
Location Address4301 X STSacramento, CA 95817-2214
Mailing Address1325 Cottonwood StWoodland, CA 95695-5131
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 21, 2016
Last NPPES UpdateFebruary 24, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2025
NPI 1245687052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in CA · PA53458
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.
4301 X ST, Sacramento, CA 95817

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

Carlos J 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 ID7517253586
PECOS Enrollment IDI20160831001657
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.

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.
128 services121 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.
111 services110 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.
59 services59 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95817 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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.

94.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.67
Improvement Activities40
Cost97.14

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.

Dietitian, Registered
4301 X ST
SACRAMENTO, CA 95817
Dietitian, Registered (Nutrition, Pediatric)
4301 X ST
SACRAMENTO, CA 95817
Student in an Organized Health Care Education/Training Program
4301 X ST
SACRAMENTO, CA 95817
Nurse Anesthetist, Certified Registered
4301 X ST
SACRAMENTO, CA 95817
Internal Medicine (Clinical Cardiac Electrophysiology)
4301 X ST
SACRAMENTO, CA 95817
Anesthesiology
4301 X ST
SACRAMENTO, CA 95817
Pediatrics
4301 X ST
SACRAMENTO, CA 95817
Emergency Medicine
4301 X ST
SACRAMENTO, CA 95817

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 Carlos Pena's NPI number?

The NPI number for Carlos Pena is 1245687052. It was assigned to this individual provider in the NPPES registry on May 21, 2016.

Where is Carlos Pena located?

Carlos Pena practices at 4301 X St, Sacramento, CA 95817. The listed phone number is (916) 734-2011.

What is Carlos Pena's specialty?

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

Is Carlos Pena enrolled in Medicare?

Yes. Carlos 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.

When was this NPI record last updated?

The NPPES record for Carlos Pena was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.