Gloria E. Garcia-Mariscal, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25592 Issued in AZ

Practice address

1535 E 10TH St
Douglas, AZ 85607-2309

Phone

(520) 805-0650

NPI assigned

Jul 7, 2006

Last updated

Mar 7, 2023By 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 13

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

University of California, San Francisco School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Copper Queen Community Hospital Hospital, Bisbee, AZ, CCN 031312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Bisbee Hospital Association

  • Critical Access Hospital
  • Bisbee, AZ
  • NPI 1518968767
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417989591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 E 10TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072309",
            "telephone_number": "520-805-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 E 10TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072309",
            "telephone_number": "520-805-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-MARISCAL",
        "first_name": "GLORIA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-03-07",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "25592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE NUMBER",
            "identifier": "25592",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285678",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF AZ",
            "identifier": "AZ0824870",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTRATIVE ENTERPRISE",
            "identifier": "B1013244",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL ARIZONA NETWORK",
            "identifier": "003468",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY CARE PLAN",
            "identifier": "285678",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE OF AZ IN",
            "identifier": "3343816",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARECOMPLETE PROVIDER",
            "identifier": "000171608",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID. NO.",
            "identifier": "86-0906731",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MUTUAL OF OMAHA",
            "identifier": "AZ9999",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE OF ARIZO",
            "identifier": "01-01097",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMDP NUMMBER",
            "identifier": "2856780",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA PHYSICIANS IPA",
            "identifier": "285678-004",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Valencia Flores
• Randall Flores, PHARMD
• Mario Fragoso, DDS
• Vicki J French, LISAC
• Janice Lee Fritsche, OTRL
• Hector F Garcia, MD
• Genoa Healthcare LLC
• Kristine L. Gomez, DDS
• Grand Canyon State Inpatient Services
• Dianey Andrea Grijalva, BS

• Family Medicine Physician in Douglas, AZ
• Providers in Douglas, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.