Individual provider Active NPI

Luz V Alicea Garcia, MD

  • Internal Medicine Physician
  • Martinsburg, WV
National Provider Identifier
1275642308
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12259 Issued in PR
Practice address
510 Butler Ave
Martinsburg, WV 25405-9991
Phone
(304) 263-0811
Fax
(304) 262-1418
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12259 PR Primary

Addresses

Primary practice location

510 Butler Ave
Martinsburg, WV 25405-9991

Mailing address

60 Don Quixote Dr
Charles Town, WV 25414-6034
Phone (787) 378-5842

Other identifiers 8

IdentifierTypeStateIssuer
1996OtherAMERICAN HEATH PLAN
89396OtherTRIPLE S
100882OtherHUMANA HEALTH INSURANCE
3217OtherPREFERRED MEDICAL CHOICE
212125OtherPREFERRED HEALTH PLAN
400259OtherMEDICARE MUCHO MAS MMM
61095OtherLA CRUZ AZUL DE PUERTO RI
PE3764OtherPAN AMERICAN LIFE INS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20210813001956 PR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8527966084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12259PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1275642308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 DON QUIXOTE DR",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254146034",
            "telephone_number": "787-378-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUTLER AVE",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254059991",
            "telephone_number": "304-263-0811",
            "fax_number": "304-262-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEA GARCIA",
        "first_name": "LUZ",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEATH PLAN",
            "identifier": "1996",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "89396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH INSURANCE",
            "identifier": "100882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICAL CHOICE",
            "identifier": "3217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH PLAN",
            "identifier": "212125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MUCHO MAS MMM",
            "identifier": "400259",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CRUZ AZUL DE PUERTO RI",
            "identifier": "61095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAN AMERICAN LIFE INS",
            "identifier": "PE3764",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.