NPIMap

Organization Active NPI

Island Medical Clinic, LLC

  • Primary Care Clinic/Center
  • McAllen, TX
National Provider Identifier
1194293969
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ISLAND MEDICAL CLINIC, LLC
Practice address
1700 W Dove Ave Ste 20
McAllen, TX 78504-4464
Phone
(956) 704-9192
Fax
(956) 615-8904
NPI assigned
Nov 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Authorized official

Name
Josue Nathan Garcia, PA-CNPI 1407128846
Title
President
Phone
(956) 491-9364

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

1700 W Dove Ave Ste 20
McAllen, TX 78504-4464

Mailing address

1700 W Dove Ave Ste 20
McAllen, TX 78504-4464
Phone (956) 704-9192

Other names 1

  • MedClinic4U Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210114001833 TX Part B Supplier - Clinic/Group Practice 9234474933 Receives reassigned benefits from 1 practitioner
Practice locations: McAllen, TX

National Provider Directory

National Provider Directory

Locations

5800 Padre Blvd
Ste 113
South Padre Island, TX 78597
Phone (956) 630-7577

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1194293969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W DOVE AVE STE 20",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785044464",
            "telephone_number": "956-704-9192",
            "fax_number": "956-615-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W DOVE AVE STE 20",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785044464",
            "telephone_number": "956-704-9192",
            "fax_number": "956-615-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JOSUE",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-491-9364",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedClinic4U",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.