NPIMap

Individual provider Active NPI

Magdiel Garcia, CRNP

  • Nurse Practitioner
  • Bangor, PA
National Provider Identifier
1346310984
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP012758 Issued in PA
Practice address
225 Erdman St
Bangor, PA 18013-2043
Phone
(610) 588-2225
Fax
(610) 588-2292
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP012758 PA Primary

Addresses

Primary practice location

225 Erdman St
Bangor, PA 18013-2043

Mailing address

225 Erdman St
Bangor, PA 18013-2043
Phone (610) 588-2225

Other identifiers 4

IdentifierTypeStateIssuer
P38305OtherPAAMERIHEALTH
50033226OtherPACAPITAL BLUE CROSS
660979OtherPAUNITED HEALTHCARE
2795062OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130320000088 PA Practitioner - Nurse Practitioner 4385545987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

225 Erdman St
Bangor, PA 18013-2043

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mak Healthcare, PC CurrentSince Jan 1, 1990 Accepting new patients
Mak Healthcare, PC CurrentSince Oct 2, 2003 Accepting new patients

Locations

225 Erdman St
Bangor, PA 18013
Phone (610) 432-9593

2094 S Delaware Dr
Mount Bethel, PA 18343
Phone (570) 897-5122

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 and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1346310984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 ERDMAN ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180132043",
            "telephone_number": "610-588-2225",
            "fax_number": "610-588-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ERDMAN ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180132043",
            "telephone_number": "610-588-2225",
            "fax_number": "610-588-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MAGDIEL",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP012758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "P38305",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50033226",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "660979",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "2795062",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, PA

Sources for this page

Verify at the official NPI Registry.