ERNESTO ANTONIO PENA-TEJEDA
NPI 1619758620
Physician Assistant - Surgical in Memphis, TN

Active since October 06, 2023PECOS EnrolledAccepts Medicare Assignment
1068 CRESTHAVEN RD STE 500, MEMPHIS, TN 38119(901) 866-8525 Get Directions Write a Review

NPPES record last updated: March 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2025, Dec 12, 2024, Oct 6, 2023 (3 updates tracked since 2023).

About Ernesto Antonio Pena-tejeda NPPES

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

ERNESTO ANTONIO PENA-TEJEDA (NPI 1619758620) is an individual surgical provider in Memphis, Tennessee, licensed in Tennessee (5999) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Memphis, and is a graduate of Louisiana State University School Of Medicine In Shreveport (2023).

NPPES Registry Identity

NPI1619758620
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameERNESTO ANTONIO PENA-TEJEDA
Location Address1068 CRESTHAVEN RD STE 500Memphis, TN 38119-0846
Mailing Address1068 Cresthaven Rd Ste 300Memphis, TN 38119-0809 · (901) 866-8864
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In ShreveportGraduated 2023
Enumeration DateOctober 6, 2023
Last NPPES UpdateMarch 13, 20253 updates tracked since enumeration
NPPES CertifiedMarch 13, 2025
NPI 1619758620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in TN · 5999
Also ListedPhysician AssistantTaxonomy 363A00000X · License 338914 (LA), 5999 (TN)
1068 CRESTHAVEN RD STE 500, Memphis, TN 38119

Secondary Practice Location 1

Location 1262 Danny Thomas PlMemphis, TN 38105-3678 · Phone (901) 595-3300

Accepted 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

Ernesto Antonio Pena-tejeda 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 ID9537519129
PECOS Enrollment IDI20240820001739
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.

Other Providers at the Same Location NPPES 14

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

Surgery (Plastic and Reconstructive Surgery)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Surgery (Plastic and Reconstructive Surgery)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Physician Assistant (Surgical)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Surgery
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Plastic Surgery
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Surgery (Plastic and Reconstructive Surgery)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119
Surgery (Plastic and Reconstructive Surgery)
1068 CRESTHAVEN RD STE 500
MEMPHIS, TN 38119

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 Ernesto Pena-tejeda's NPI number?

The NPI number for Ernesto Pena-tejeda is 1619758620. It was assigned to this individual provider in the NPPES registry on October 6, 2023.

Where is Ernesto Pena-tejeda located?

Ernesto Pena-tejeda practices at 1068 Cresthaven Rd Ste 500, Memphis, TN 38119. The listed phone number is (901) 866-8525.

What is Ernesto Pena-tejeda's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Ernesto Pena-tejeda enrolled in Medicare?

Yes. Ernesto Pena-tejeda 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 Ernesto Pena-tejeda accept?

Health plans from BlueCross BlueShield of Tennessee, Oscar Health Plan, Inc., Oscar Insurance Company and UnitedHealthcare list Ernesto Pena-tejeda 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.

When was this NPI record last updated?

The NPPES record for Ernesto Pena-tejeda was last updated on March 13, 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.