NPIMap

Individual provider Active NPI

John M Garcia, PA C

  • Medical Physician Assistant
  • Tacoma, WA
National Provider Identifier
1114997681
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50001969 Issued in OH
Practice address
1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone
(253) 722-2161
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 50001969 OH Primary

Addresses

Primary practice location

1148 Broadway Ste 100
Tacoma, WA 98402-3518

Mailing address

1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone (253) 722-2161

Other practice location 1

1800 Cooks Hill Rd Ste G
Centralia, WA 98531-9162
Phone (360) 736-3042

Other practice location 2

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Other identifiers 1

IdentifierTypeStateIssuer
1057175MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200511001904 WA Practitioner - Physician Assistant 9638271208 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
50.5 of 100Reported as group
Quality
44.61
Promoting interoperability
0
Improvement activities
40
Cost
50.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Mar 18, 2020 Accepting new patients
Lewis County Community Health Services CurrentSince Mar 18, 2020 Accepting new patients
Dispatchhealth Advanced Care - Washington PC PastSince Oct 21, 2020 Accepting new patients
Market Street Emergency Physicians LLC Past Accepting new patients
Emergency Professionals of Ohio, Inc. Past Accepting new patients

Locations

1800 Cooks Hill Rd
Ste G
Centralia, WA 98531
Phone (360) 736-3042

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1114997681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-722-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-722-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Cooks Hill Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985319162",
            "country_code": "US",
            "telephone_number": "360-736-3042",
            "fax_number": "360-736-2967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2690 NE Kresky Ave",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985322412",
            "country_code": "US",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50001969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057175",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.