Individual provider Active NPI

Andrew R Garrett, D.O.

  • Neurology Physician
  • San Diego, CA
National Provider Identifier
1104205368
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
13139587-1204 Issued in UT
Practice address
34800 Bob Wilson Dr
Internal Medicine
San Diego, CA 92134-3300
Phone
(619) 532-9795
Fax
(619) 532-7508
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Neurology Physician 2084N0400X 13139587-1204 UT Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
Internal Medicine
San Diego, CA 92134-3300

Mailing address

34800 Bob Wilson Dr
Internal Medicine
San Diego, CA 92134-3300
Phone (619) 532-9795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901001746 UT Practitioner - Neurology 4284013020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Creek Neurosurgery, LLCGroup PAC ID 9537387790, 4 clinicians

Practice addresses (Care Compare)

15 S 1000
Suite 225
Payson, UT 84651-5593
Phone (801) 609-9310

Hospital & facility affiliations

  • Castleview Hospital Hospital, Price, UT, CCN 460011
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Mountain View Hospital Hospital, Payson, UT, CCN 460013
  • Timpanogos Regional Hospital Hospital, Orem, UT, CCN 460052
  • Intermountain Health Sanpete Valley Hospital Hospital, Mount Pleasant, UT, CCN 461303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Creek Neurosurgery, LLC CurrentSince Jul 18, 2023 Accepting new patients

Locations

1248 E 90 N
Ste 203
American Fork, UT 84003
Phone (385) 498-7506

15 S 1000 E
Ste 225
Payson, UT 84651
Phone (801) 465-2511

Interoperability endpoints

  • Direct secure messaging: andrewgarrett@rcn.gwaydirect.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1845

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1104205368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "INTERNAL MEDICINE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921343300",
            "telephone_number": "619-532-9795",
            "fax_number": "619-532-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "INTERNAL MEDICINE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921343300",
            "telephone_number": "619-532-9795",
            "fax_number": "619-532-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "ANDREW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "13139587-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.