Individual provider Active NPI

Armando J Garcia, PA-C

  • Medical Physician Assistant
  • Lakewood, WA
National Provider Identifier
1619997657
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10003331 Issued in WA
Practice address
10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036
Phone
(253) 589-7030
Fax
(253) 589-7033
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003331 WA Primary

Addresses

Primary practice location

10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036

Mailing address

1019 Pacific Ave Ste 300
Attn HR
Tacoma, WA 98402-4488
Phone (253) 597-4550

Other identifiers 1

IdentifierTypeStateIssuer
8317166MedicaidWA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824000748 WA Practitioner - Physician Assistant 4082738349 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003331WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care CurrentSince Sep 9, 2002 Accepting new patients
Community Health Care CurrentSince Sep 9, 2002 Accepting new patients

Locations

134 188th St S
Spanaway, WA 98387
Phone (253) 847-2304

10510 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 589-7030

1148 Broadway
Ste 100
Tacoma, WA 98402
Phone (253) 441-4742

101 E 26th St
Tacoma, WA 98421
Phone (253) 579-4550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1619997657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE STE 300",
            "address_2": "ATTN HR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024488",
            "telephone_number": "253-597-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995036",
            "telephone_number": "253-589-7030",
            "fax_number": "253-589-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ARMANDO",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8317166",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.