Active NPI
Juan Jose Garcia Jr., PA-C, ATC
- Medical Physician Assistant
- Washington, DC
National Provider Identifier
1508130378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110-008889
- Practice address
- 1650 17TH St. NW
Washington, DC 20500 - Phone
- (202) 814-7289
- NPI assigned
- Feb 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | 52298 | CA | |
| Medical Physician Assistant | 363AM0700X | 0110-008889 | VA | Primary |
Addresses
Primary practice location
1650 17TH St. NW
Washington, DC 20500
Mailing address
10719 Old Colchester Rd
Lorton, VA 22079-3612
Other practice location 1
374 MDG
Unit 5071
Apo, AP 96328-5071
Phone (315) 225-3575
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110-008889 | VA | MD | Medical Physician Assistant |
| 52298 | CA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670976000000",
"number": "1508130378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10719 OLD COLCHESTER RD",
"city": "LORTON",
"state": "VA",
"postal_code": "220793612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 17TH ST. NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20500",
"telephone_number": "202-814-7289"
}
],
"practiceLocations": [
{
"address_1": "374 MDG",
"address_2": "Unit 5071",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "963285071",
"country_code": "US",
"telephone_number": "315-225-3575",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "GARCIA",
"first_name": "JUAN",
"middle_name": "JOSE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-26",
"last_updated": "2022-12-14",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "52298",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110-008889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.