Organization Active NPI

Ivan H Garcia MD PC

  • Specialist
  • Baltimore, MD
National Provider Identifier
1417986712
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
IVAN H GARCIA MD PC
Practice address
2925 Lord Baltimore Dr.
Suite 300
Baltimore, MD 21244-2566
Phone
(410) 277-3937
Fax
(410) 281-9388
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Edward John Wasloski, O.D.
Title
Founding Member
Phone
(410) 281-2656

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD Primary

Addresses

Primary practice location

2925 Lord Baltimore Dr.
Suite 300
Baltimore, MD 21244-2566

Mailing address

2925 Lord Baltimore Dr.
Suite 300
Baltimore, MD 21244-2566
Phone (410) 277-3937

Other identifiers 2

IdentifierTypeStateIssuer
078561000MedicaidMD
4125061000MedicaidMD

Other names 1

  • Omni Eye Specialists Other name

National Provider Directory

National Provider Directory

Locations

7939 Honeygo Blvd
Ste 100
Baltimore, MD 21236
Phone (410) 931-4500

9 Schilling Rd
#L13
Hunt Valley, MD 21031
Phone (410) 277-3937

9106 Philadelphia Rd
Ste 314
Rosedale, MD 21237
Phone (410) 277-3937

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417986712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 LORD BALTIMORE DR.",
            "address_2": "SUITE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442566",
            "telephone_number": "410-277-3937",
            "fax_number": "410-281-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 LORD BALTIMORE DR.",
            "address_2": "SUITE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442566",
            "telephone_number": "410-277-3937",
            "fax_number": "410-281-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN H GARCIA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WASLOSKI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "FOUNDING MEMBER",
        "authorized_official_telephone_number": "410-281-2656",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078561000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4125061000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Eye Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.