NPIMap

Individual provider Active NPI

Sean Brandon Garcia

  • Physician Assistant
  • Casa Grande, AZ
National Provider Identifier
1295406361
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9458 Issued in AZ
Practice address
580 N Camino Mercado Ste 8
Casa Grande, AZ 85122-5757
Phone
(520) 381-0380
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9458 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

580 N Camino Mercado Ste 8
Casa Grande, AZ 85122-5757

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Other identifiers 1

IdentifierTypeStateIssuer
9458OtherAZARIZONA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20221122001589 AZ Practitioner - Physician Assistant 5799153730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun Life Family Health Center Inc 46 clinicians

Practice addresses (Care Compare)

1856 E Florence Blvd
Casa Grande, AZ 85122-5303
Phone (520) 836-5036

580 N Camino Mercado
Suite 8
Casa Grande, AZ 85122-5757
Phone (520) 381-0381

865 N Arizola Rd
Casa Grande, AZ 85122-6011
Phone (520) 836-3446

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9458AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Life Family Health Center, Inc. CurrentSince Nov 7, 2022 Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients

Locations

580 N Camino Mercado
Ste 8
Casa Grande, AZ 85122
Phone (520) 381-0380

865 N Arizola Rd
Casa Grande, AZ 85122
Phone (520) 381-0363

655 S Dobson Rd
Ste 201
Chandler, AZ 85224
Phone (480) 307-9471

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1295406361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 N CAMINO MERCADO STE 8",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225757",
            "telephone_number": "520-381-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "SEAN",
        "middle_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9458",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA LICENSE",
            "identifier": "9458",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.