NICOLE PENA D.O.
NPI 1811322274
Neuromusculoskeletal Medicine & OMM in Fairfield, CA

Q: What is Nicole Pena's NPI number?

The NPI number for Nicole Pena is 1811322274. It was assigned to this individual provider in the NPPES registry on September 4, 2013.

Q: What is Nicole Pena's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Pena was last updated on April 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since September 04, 2013PECOS Enrolled

2201 COURAGE DR, FAIRFIELD, CA 94533(707) 469-4640 Get Directions Write a Review

NPPES record last updated: April 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 11, 2022, Oct 11, 2016 (2 updates tracked since 2016).

On this page

About Nicole Pena D.o. NPPES

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

NICOLE PENA D.O. (NPI 1811322274) is an individual neuromusculoskeletal medicine & omm provider in Fairfield, California, licensed in California (20A14813) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811322274

Entity TypeIndividualFemale

Primary Taxonomy204D00000X

Provider Legal NameNICOLE PENACredential: D.O.

Location Address2201 COURAGE DRFairfield, CA 94533-6733

Mailing Address1310 Club DrVallejo, CA 94592-1187 · (707) 638-5217

Phone(707) 469-4640

Sole ProprietorNo

Enumeration DateSeptember 4, 2013

Last NPPES UpdateApril 11, 20222 updates tracked since enumeration

NPPES CertifiedApril 11, 2022

✔ NPI 1811322274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians

Taxonomy Code204D00000X

License✔ Licensed in CA · 20A14813

Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.

2201 COURAGE DR, Fairfield, CA 94533

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Pena D.o. 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.

Other Providers at the Same Location NPPES 18

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

REBECCA J PEREZ NP

Nurse Practitioner (Family)