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DR. TERESA A PENA MD
NPI 1720030083
Family Medicine in White Bear Lake, MN

Active since May 16, 2006Opted out of Medicare · through Apr 1, 2027
4525 WHITE BEAR PKWY, SUITE 130, WHITE BEAR LAKE, MN 55110(651) 564-4884 Get Directions Write a Review

NPPES record last updated: October 22, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Teresa A Pena Md NPPES

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

DR. TERESA A PENA MD (NPI 1720030083) is an individual family medicine provider in White Bear Lake, Minnesota, licensed in Minnesota (42447) and active in the NPI registry since May 2006. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1720030083
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. TERESA A PENACredential: MD
Location Address4525 WHITE BEAR PKWY, SUITE 130White Bear Lake, MN 55110-7651
Mailing Address4525 White Bear Pkwy, Suite 130White Bear Lake, MN 55110-7651 · (651) 564-4884
Phone(651) 564-4884
Sole ProprietorNo
Enumeration DateMay 16, 2006
Last NPPES UpdateOctober 22, 2018
✔ NPI 1720030083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 42447
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4525 WHITE BEAR PKWY, White Bear Lake, MN 55110
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Teresa A Pena Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2023 through April 1, 2027.

Opt-Out Effective DateApril 1, 2023
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55110 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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 Teresa Pena's NPI number?

The NPI number for Teresa Pena is 1720030083. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Teresa Pena located?

Teresa Pena practices at 4525 White Bear Pkwy Suite 130, White Bear Lake, MN 55110. The listed phone number is (651) 564-4884.

What is Teresa Pena's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Teresa Pena enrolled in Medicare?

No. Teresa Pena has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Teresa Pena accept?

Health plans from Blue Cross and Blue Shield of Texas list Teresa Pena 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 Teresa Pena was last updated on October 22, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.