Individual provider Active NPI

Ron Martin Garcia Menorca, MD

  • Family Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1124407275
Registry record updated Nov 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145391 Issued in CA
Practice address
14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone
(703) 490-8400
NPI assigned
May 21, 2015
Last updated
Nov 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A145391 CA Primary

Addresses

Primary practice location

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644

Mailing address

12918 Pintail Rd
Woodbridge, VA 22192-3831
Phone (916) 479-4544

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211007001654 VA Practitioner - Internal MedicinePractitioner - Family Practice 1052681780 Reassigns benefits to 1 organization
I20230131001337 DC Practitioner - Family Practice 1052681780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
University of Rochester School of Medicine and Dentistry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14139 Potomac Mills Rd
Woodbridge, VA 22192-4644
Phone (703) 257-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145391CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 20, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine CurrentSince Oct 18, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Oct 18, 2021 Accepting new patients

Locations

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1637366400000",
    "number": "1124407275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12918 PINTAIL RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923831",
            "telephone_number": "916-479-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14139 POTOMAC MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924644",
            "telephone_number": "703-490-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENORCA",
        "first_name": "RON MARTIN",
        "middle_name": "GARCIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "14139 Potomac Mills Rd",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221924644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.