Stacia M Jacobi-Garcia, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2562 Issued in NM

Practice address

7110 Wyoming Blvd NE
Albuquerque, NM 87109-4867

Phone

(505) 883-8111

Fax

(505) 888-8942

NPI assigned

Dec 29, 2006

Last updated

Jun 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kewa Pueblo Health CorporationGroup PAC ID 7618137779, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stacia.jacobigarcia.p1@direct.kp-hc.nextgenshare.com

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.

• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888

  TX

  Medicare reassignment Care Compare group
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)
• Assured Imaging Women's Wellness of Southern Arizona, LLC

  • Diagnostic Radiology Physician
  • Tucson, AZ
  • NPI 1932245974
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1376609636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094867",
            "telephone_number": "505-883-8111",
            "fax_number": "505-888-8942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094867",
            "telephone_number": "505-883-8111",
            "fax_number": "505-888-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBI-GARCIA",
        "first_name": "STACIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "2562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED COLE SUPERIOR",
            "identifier": "222198",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "55144",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyson A Jackson, MD
• Williemae Jackson
• Jacob P. Torrez, LCSW, LLC.
• Athira Jacob
• Shatoya F Jacob
• Jay Jacobi, MD
• Sarah M Jacobi
• Aaron Jacobs, MD
• Alexandra Jacobs, IBCLC
• Kari Jacobs

• Optometrist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.