Individual provider Active NPI

Ginx Ivelisse Garcia, PA-C

  • Physician Assistant
  • Florham Park, NJ
National Provider Identifier
1417825225
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
034770 Issued in NY
Practice address
200 Park Ave
Florham Park, NJ 07932-1026
Phone
(973) 443-8401
NPI assigned
Oct 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 034770 NY Primary

Addresses

Primary practice location

200 Park Ave
Florham Park, NJ 07932-1026

Mailing address

200 Park Ave
Florham Park, NJ 07932-1026
Phone (973) 443-8401

Other practice location 1

10740 Queens Blvd Ste 204
Forest Hills, NY 11375-4252
Phone (718) 459-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260424000384 NY Practitioner - Physician Assistant 9931676277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1417825225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321026",
            "telephone_number": "973-443-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321026",
            "telephone_number": "973-443-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10740 Queens Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754252",
            "country_code": "US",
            "telephone_number": "718-459-0900",
            "fax_number": "718-459-0910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GINX",
        "middle_name": "IVELISSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-24",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

Verify at the official NPI Registry.