Individual provider Active NPI

Georgina De la Garza

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1518316611
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60943336 Issued in WA
Practice address
120 W Mission Ave
Spokane, WA 99201-2358
Phone
(509) 326-4343
Fax
(509) 329-2280
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL0006289 CO
Obstetrics & Gynecology Physician 207V00000X MD60943336 WA
Family Medicine Physician 207Q00000X MD60943336 WA Primary

Addresses

Primary practice location

120 W Mission Ave
Spokane, WA 99201-2358

Mailing address

120 W Mission Ave
Spokane, WA 99201-2358
Phone (509) 326-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191223000071 WA Practitioner - Family Practice 7719245158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1212 N Pines Rd
Spokane Valley, WA 99206-4939
Phone (509) 893-8140

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL0006289COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Oct 24, 2022 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Oct 24, 2022 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

1212 N Pines Rd
Spokane Valley, WA 99206
Phone (509) 474-5445

Interoperability endpoints

  • Direct secure messaging: gdelagarza438206@direct.multicare.org
  • Direct secure messaging: gdelagarza30031@yvfwc.direct-ci.com
  • Direct secure messaging: gdelagarza2596362@wm.providencedirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1518316611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MISSION AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012358",
            "telephone_number": "509-326-4343",
            "fax_number": "509-329-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MISSION AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012358",
            "telephone_number": "509-326-4343",
            "fax_number": "509-329-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GARZA",
        "first_name": "GEORGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL0006289",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60943336",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60943336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.