Individual provider Active NPI

Giselle Lucia Garcia, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Elmhurst, NY
National Provider Identifier
1477391837
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
40-12 80TH Street
Elmhurst, NY 11373
Phone
(718) 886-9000
NPI assigned
Jul 18, 2024
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 NU Primary

Addresses

Primary practice location

40-12 80TH Street
Elmhurst, NY 11373

Mailing address

4012 80TH St
Elmhurst, NY 11373-1234

Other names 1

  • Gisell Lucia Garcia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241023002167 NY Practitioner - Physician Assistant 0749713212 Reassigns benefits to 1 organization
I20251230000304 NJ Practitioner - Physician Assistant 0749713212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Dermatology of Ny,P.C.Group PAC ID 3779761705, 18 clinicians

Practice addresses (Care Compare)

25707 Union Tpke
Glen Oaks, NY 11004-1250
Phone (718) 886-9000

4012 80TH St
Elmhurst, NY 11373-1234
Phone (718) 886-9000

41 -61 Kissena Blvd
5A
Flushing, NY 11355-3105

4161 Kissena Blvd
Suite 5a
Flushing, NY 11355-3105
Phone (718) 886-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Dermatology of NJ,PA CurrentSince Nov 18, 2025 Accepting new patients

Locations

2175 Lemoine Ave
Fl 6
Fort Lee, NJ 07024
Phone (201) 585-4612

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1477391837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 80TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40-12 80TH STREET",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-886-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "GISELLE",
        "middle_name": "LUCIA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GISELL",
            "last_name": "GARCIA",
            "middle_name": "LUCIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.