Individual provider Active NPI

Amanda Rose Garcia, PHARMD

  • Pharmacist
  • Elbridge, NY
National Provider Identifier
1598097107
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053601 Issued in NY
Practice address
1057 Route 5 East
Elbridge, NY 13060
Phone
(315) 689-6111
Fax
(315) 689-1628
NPI assigned
Feb 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053601 NY Primary

Addresses

Primary practice location

1057 Route 5 East
Elbridge, NY 13060

Mailing address

1057 Route 5 East
Elbridge, NY 13060
Phone (315) 689-6111

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
053601NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KPH Healthcare Services, Inc. Past Accepting new patients
KPH Healthcare Services, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1598097107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 ROUTE 5 EAST",
            "city": "ELBRIDGE",
            "state": "NY",
            "postal_code": "13060",
            "telephone_number": "315-689-6111",
            "fax_number": "315-689-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 ROUTE 5 EAST",
            "city": "ELBRIDGE",
            "state": "NY",
            "postal_code": "13060",
            "telephone_number": "315-689-6111",
            "fax_number": "315-689-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-06",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elbridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.