Active NPI
Michael J Garcia, MD
- Diagnostic Radiology Physician
- Janesville, WI
National Provider Identifier
1396820676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 43102
- Practice address
- 907 Cambridge Dr
Janesville, WI 53548-6707 - Phone
- (608) 758-8976
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 43102 | WI | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 036-047663 | IL |
Addresses
Primary practice location
907 Cambridge Dr
Janesville, WI 53548-6707
Mailing address
907 Cambridge Dr
Janesville, WI 53548-6707
Phone (608) 758-8976
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036047663 3 | Medicaid | IL | |
| 34085400 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-047663 | IL | MD | Diagnostic Radiology Physician |
| 43102 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
2310 1st Center Ave
Brodhead, WI 53520
Phone (608) 897-8664
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
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.
-
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345420800000",
"number": "1396820676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 CAMBRIDGE DR",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535486707",
"telephone_number": "608-758-8976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 CAMBRIDGE DR",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535486707",
"telephone_number": "608-758-8976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2012-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "43102",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036-047663",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036047663 3",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34085400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.