DR. CARLOS PENA M.D.
NPI 1669435988
Internal Medicine - Nephrology in Miami, FL

Q: What is Carlos Pena's NPI number?

The NPI number for Carlos Pena is 1669435988. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Q: What is Carlos Pena's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Carlos Pena was last updated on November 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 08, 2006PECOS EnrolledAccepts Medicare Assignment

89.05/100

CMS Quality Rating

16501 NW 2ND AVE, MIAMI, FL 33169(305) 354-4558 Get Directions Write a Review

NPPES record last updated: November 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 3, 2022, Nov 16, 2016 (2 updates tracked since 2016).

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About Dr. Carlos Pena M.d. NPPES

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

DR. CARLOS PENA M.D. (NPI 1669435988) is an individual nephrology provider in Miami, Florida, licensed in Florida (ME54800) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Aventura Hospital, and maintains a secondary practice location in Aventura.

NPPES Registry Identity

NPI1669435988

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. CARLOS PENACredential: M.D.

Location Address16501 NW 2ND AVEMiami, FL 33169-6005

Mailing Address16501 Nw 2nd AveMiami, FL 33169-6005 · (305) 354-4558

Phone(305) 354-4558

Sole ProprietorNo

Medical School CMSUniversity Central Del Caribe Escuela De MedicinaGraduated 1982

Enumeration DateApril 8, 2006

Last NPPES UpdateNovember 3, 20222 updates tracked since enumeration

NPPES CertifiedNovember 3, 2022

✔ NPI 1669435988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in FL · ME54800

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedSpecialistTaxonomy 174400000X

16501 NW 2ND AVE, Miami, FL 33169

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Secondary Practice Location 1

Location 119056 NE 29th AveAventura, FL 33180-2802 · Phone (305) 354-4558 · Fax (305) 354-3884

Other Identifiers 1

Medicaid062529900FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Florida Blue (BlueCross BlueShield FL) 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. Carlos 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 ID7618044017

PECOS Enrollment IDI20080927000064

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 7

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.

218 services73 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

111 services22 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.

60 services54 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

58 services28 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.

47 services40 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

41 services19 patients

Hospital Affiliations CMS Care Compare

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

Hca Florida Aventura Hospital

Acute Care Hospitals · Aventura, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100131

Location20900 Biscayne BlvdAventura, FL 33180 · Miami-Dade County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33169 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

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.

89.05/100

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

Individually scored

Quality

62.45

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

0%103 patients1/55-star benchmark: 93%

Cervical Cancer Screening

6%64 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

19%267 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

51%249 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

0%125 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

50%125 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

55%1,644 patients2/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%301 patients1/55-star benchmark: 100%

HIV Screening

6%183 patients1/55-star benchmark: 60%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

46%477 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

1%454 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

24%345 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 91% · 328 patients

Patients screened: 98% · 328 patients

9%22 patients1/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

77%185 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

86%307 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 315 patients

Patients totalRate: 0% · 315 patients

0%315 patients5/55-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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier13 claims2,340 services$0.29 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier13 claims2,340 services$0.18 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

1 supplier17 claims17 services$11.87 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

GREATER MIAMI NEPHROLOGY ASSOCIATES PA

Internal Medicine (Nephrology)