Individual provider Active NPI

Marian Stacey Garcia, PA

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1619755154
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5109 Issued in OK
Practice address
1504 NE 9TH St
Oklahoma City, OK 73117-2806
Phone
(405) 514-1722
NPI assigned
Sep 18, 2023
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5109 OK Primary

Addresses

Primary practice location

1504 NE 9TH St
Oklahoma City, OK 73117-2806

Mailing address

1504 NE 9TH St
Oklahoma City, OK 73117-2806
Phone (405) 514-1722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001725 OK Practitioner - Physician Assistant 1052754579 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5109OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Wellness Stroud Inc. CurrentSince Jan 1, 2026 Accepting new patients
Rural Wellness Stroud Inc. CurrentSince Jan 1, 2026 Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
Purcell Municipal Hospital Past Accepting new patients

Locations

2308 W Highway 66
Stroud, OK 74079
Phone (918) 968-3571

Interoperability endpoints

  • Direct secure messaging: mgarcia497003@direct-ehr-ssmhc.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1619755154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 NE 9TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731172806",
            "telephone_number": "405-514-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 NE 9TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731172806",
            "telephone_number": "405-514-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MARIAN",
        "middle_name": "STACEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.