Jose Manuel Pena, MD in Peoria, IL

Jose Manuel Pena, MD is a medicare enrolled "Pediatrics" physician in Peoria, Illinois. His current practice location is 530 Ne Glen Oak Ave, Peoria, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 655-2274.

Jose Manuel Pena is licensed to practice in Illinois (license number 125.070535) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770013583.

Contact Information

	Jose Manuel Pena, MD
	530 Ne Glen Oak Ave, Peoria, IL 61637-0001
	(309) 655-2274
	Not Available

Map and Direction

Physician's Profile

Full Name	Jose Manuel Pena
Gender	Male
Speciality	Pediatrics
Location	530 Ne Glen Oak Ave, Peoria, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770013583
Provider Enumeration Date: 06/14/2017
Last Update Date: 06/14/2017

Medicare PECOS Information:

PECOS PAC ID: 7911271598
Enrollment ID: I20200914002562

Medical Identifiers

Medical identifiers for Jose Manuel Pena such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770013583	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	125.070535 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jose Manuel Pena allows following entities to bill medicare on his behalf.

Entity Name	St Lukes Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jose Manuel Pena is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jose Manuel Pena, MD 2401 W Alta Rd Apt 602, Peoria, IL 61615-1287 Ph: (602) 999-3249	Jose Manuel Pena, MD 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 Ph: (309) 655-2274

Reviews and Comments

Pediatrics Doctors in Peoria, IL

Thomas James Mcmorrow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602
Jessica Ford-davis, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2274
Kelsey Elizabeth Grimes, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000
Jessica N Mistretta, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2000
Mrs. Valeria Claudia Benavides Lopez, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-3313
Khalid Al Katranji, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7171
Dr. Gretchen L Kopec, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-0615

Jose Manuel Pena, MD - Medicare Pediatrics in Peoria, IL