Active NPI
Jose Mennen B Garcia, MD
- Pediatrics Physician
- Tucson, AZ
National Provider Identifier
1487632022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24534
- Practice address
- 1310 W Saint Marys Rd
Tucson, AZ 85745-3170 - Phone
- (520) 622-1366
- Fax
- (520) 622-1384
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24534 | AZ | Primary |
Addresses
Primary practice location
1310 W Saint Marys Rd
Tucson, AZ 85745-3170
Mailing address
1310 W St Marys Rd
Tucson, AZ 85745
Phone (520) 622-1366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 359796 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24534 | AZ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1487632022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 W ST MARYS RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85745",
"telephone_number": "520-622-1366",
"fax_number": "520-622-1384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 W SAINT MARYS RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857453170",
"telephone_number": "520-622-1366",
"fax_number": "520-622-1384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "JOSE",
"middle_name": "MENNEN B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "24534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "359796",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.