Individual provider Active NPI

Annery G Garcia-Marcinkiewicz, MD

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1265726475
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD455285 Issued in PA
Practice address
3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319
Phone
(215) 590-1858
NPI assigned
Jun 6, 2011
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X MD455285 PA Primary
Anesthesiology Physician 207L00000X 55285 MN

Addresses

Primary practice location

3401 Civic Center Blvd Ste 9329
Philadelphia, PA 19104-4319

Mailing address

100 Penn Square East
9TH Floor North-Caa
Philadelphia, PA 19107-3323
Phone (267) 425-9309

Other names 1

  • Annery G Garcia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170309001305 PA Practitioner - Anesthesiology 4183871668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1858

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD455285PAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Anesthesiology Associates, LTD Anesthesiology CurrentSince Jan 26, 2019 Accepting new patients
Children's Anesthesiology Associates, LTD Anesthesiology CurrentSince Jan 26, 2019 Accepting new patients

Locations

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Ste 9329
Philadelphia, PA 19104
Phone (267) 425-9300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1265726475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PENN SQUARE EAST",
            "address_2": "9TH FLOOR NORTH-CAA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9309",
            "fax_number": "267-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD STE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-MARCINKIEWICZ",
        "first_name": "ANNERY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD455285",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "55285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNERY",
            "last_name": "GARCIA",
            "middle_name": "G",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.