Individual provider Active NPI

Mary Carmen Garcia-Kumirov, M.D.

  • Family Medicine Physician
  • Nogales, AZ
National Provider Identifier
1487041216
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55088 Issued in AZ
Practice address
1852 N Mastick Way
Nogales, AZ 85621
Phone
(520) 281-1550
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R74899 AZ
Family Medicine Physician 207Q00000X 55088 AZ Primary

Addresses

Primary practice location

1852 N Mastick Way
Nogales, AZ 85621

Mailing address

825 N Grand Ave Ste 100
Nogales, AZ 85621-1061
Phone (520) 761-2133

Other practice location 1

9700 N 91st St Ste A115
Scottsdale, AZ 85258-5036
Phone (888) 803-3370

Other identifiers 1

IdentifierTypeStateIssuer
330385MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180115000292 AZ Practitioner - Family Practice 9638438989 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13055 W McDowell Rd
Suite E101
Avondale, AZ 85392-6460
Phone (623) 235-8625

1852 N Mastick Way
Nogales, AZ 85621-1063
Phone (520) 281-1550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55088AZMDFamily Medicine Physician
R74899AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc Family Medicine Current Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Jul 1, 2018 Accepting new patients
Mariposa Community Health Center, Inc Family Medicine Current Accepting new patients
Circle Medical Care Group PA Family Medicine CurrentSince Oct 31, 2025 Accepting new patients
Mariposa Community Health Center, Inc Family Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

507 N Western Ave
Nogales, AZ 85621
Phone (520) 229-0085

1852 N Mastick Way
Nogales, AZ 85621

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

9700 N 91st St
Ste A115
Scottsdale, AZ 85258
Phone (480) 922-1376

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

Interoperability endpoints

  • Direct secure messaging: maryc.garcia.p1@direct.azch.nextgenshare.com

Organizations & group practices 6

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.

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1487041216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-761-2133",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "85621",
            "telephone_number": "520-281-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9700 N 91st St Ste A115",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585036",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA-KUMIROV",
        "first_name": "MARY",
        "middle_name": "CARMEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R74899",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "55088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330385",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

Verify at the official NPI Registry.