Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ANNA DE LA PENA M.D
NPI 1659650471
Hospitalist in Grafton, WI

Q: What is Anna De La Pena's NPI number?

The NPI number for Anna De La Pena is 1659650471. It was assigned to this individual provider in the NPPES registry on August 10, 2011.

Q: What is Anna De La Pena's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Anna De La Pena was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days 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 August 10, 2011PECOS Enrolled

75.75/100

CMS Quality Rating

975 PORT WASHINGTON RD, GRAFTON, WI 53024(262) 329-1000 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 8, 2025, Apr 11, 2025 (2 updates tracked since 2025).

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About Anna De La Pena M.d NPPES

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

ANNA DE LA PENA M.D (NPI 1659650471) is an individual hospitalist provider in Grafton, Wisconsin, licensed in Wisconsin (62390-20) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS, is affiliated with Aurora St Lukes Medical Center, and maintains a secondary practice location in Evanston.

NPPES Registry Identity

NPI1659650471

Entity TypeIndividualFemale

Primary Taxonomy208M00000X

Provider Legal NameANNA DE LA PENACredential: M.D

Location Address975 PORT WASHINGTON RDGrafton, WI 53024-9201

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(262) 329-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateAugust 10, 2011

Last NPPES UpdateOctober 23, 20262 updates tracked since enumeration

NPPES CertifiedOctober 23, 2026

✔ NPI 1659650471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

Licenses✔ Licensed in WI · 62390-20✔ Licensed in MD · 62390-20

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 125059545 (IL)

975 PORT WASHINGTON RD, Grafton, WI 53024

Open in Google Maps ↗

Secondary Practice Location 1

Location 12650 Ridge AveEvanston, IL 60201-1718 · Phone (847) 570-2700

Other Identifiers 1

Medicaid100038124WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).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

Anna De La Pena M.d 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 ID2567686041

PECOS Enrollment IDI20140624002367

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.

Medicare Billing Reassignments

Medicare enrollment records show Anna De La Pena reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Columbia St. Mary's Hospital Milwaukee, Inc

4.7 mi

Multi-Specialty

13111 N PORT WASHINGTON RD
Mequon, WI 53097

Reassigned Medicare billing, Wisconsin enrollment
Medicare enrollment name: Columbia St Marys Hospital Milwaukee Inc
856 clinicians in this Medicare group

NPI 1710928221 (414) 270-4932

Ascension Medical Group-Southeast Wisconsin Inc

15 mi

Internal Medicine

400 W RIVER WOODS PKWY
Glendale, WI 53212

Reassigned Medicare billing, Wisconsin enrollment
1,343 clinicians in this Medicare group

NPI 1609881077 (414) 465-3000

Aurora Medical Group, Inc.

23 mi

Obstetrics & Gynecology

8905 W LINCOLN AVE, SUITE 515
West Allis, WI 53227

Reassigned Medicare billing, Wisconsin enrollment
4,609 clinicians in this Medicare group

NPI 1457592735 (414) 328-8650

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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

96 services53 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

50 services33 patients

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.

27 services27 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

14 services12 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520138

Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County

Emergency services Birthing friendly

Aurora Medical Center

Acute Care Hospitals · Grafton, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520207

Location975 Port Washington RoadGrafton, WI 53024 · Ozaukee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53024 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

75.75/100

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

Scored as part of a group practice

Quality

78.16

Promoting Interoperability

Improvement Activities

Cost

57.63

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.

ANNE R. HARLEY P.T.

Physical Therapist