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JOSE MANUEL PENA MD
NPI 1770013583
Pediatrics in Peoria, IL

Active since June 14, 2017PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2274 Get Directions Write a Review

NPPES record last updated: June 14, 2017. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jose Manuel Pena Md NPPES

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

JOSE MANUEL PENA MD (NPI 1770013583) is an individual pediatrics provider in Peoria, Illinois, licensed in Illinois (125.070535) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770013583
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameJOSE MANUEL PENACredential: MD
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address2401 W Alta Rd Apt 602Peoria, IL 61615-1287 · (602) 999-3249
Phone(309) 655-2274
Sole ProprietorYes
Enumeration DateJune 14, 2017
✔ NPI 1770013583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 125.070535
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
530 NE GLEN OAK AVE, Peoria, IL 61637
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jose Manuel Pena Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Jose Pena reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Luke's Clinic LLC
1,291 mi
Family Medicine
775 POLE LINE RD W
Twin Falls, ID 83301
  • Reassigned Medicare billing, Idaho enrollment
  • Medicare enrollment name: St Lukes Clinic LLC
  • 322 clinicians in this Medicare group
NPI 1790718229 (208) 814-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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.

DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109
ABIGAIL V. WELU DO
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-6710
DR. JAMES DANIEL DEWAR D.O.
Internal Medicine (Interventional Cardiology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-7257

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 Jose Pena's NPI number?

The NPI number for Jose Pena is 1770013583. It was assigned to this individual provider in the NPPES registry on June 14, 2017.

Where is Jose Pena located?

Jose Pena practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2274.

What is Jose Pena's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jose Pena enrolled in Medicare?

Yes. Jose Pena is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jose Pena's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jose Pena reassigns Medicare benefits to St Luke's Clinic LLC (Twin Falls, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jose Pena's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jose Pena accept?

Health plans from Select Health list Jose 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 Jose Pena was last updated on June 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.