Individual provider Active NPI

Oswaldo Garcia, NP

  • Family Nurse Practitioner
  • Port Jefferson Station, NY
National Provider Identifier
1639866122
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F351684-01 Issued in NY
Practice address
5225 Nesconset Hwy
Port Jefferson Station, NY 11776-2053
Phone
(631) 509-3516
NPI assigned
Apr 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F351684-01 NY Primary

Addresses

Primary practice location

5225 Nesconset Hwy
Port Jefferson Station, NY 11776-2053

Mailing address

33 Nims Ave
West Babylon, NY 11704-6304
Phone (516) 451-0074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240404001842 NY Practitioner - Nurse Practitioner 4789022195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F351684-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine & Rehabilitation of Long Island CurrentSince Feb 18, 2024 Accepting new patients
Digestive Disease Care, PC Past Accepting new patients

Locations

234 Orinoco Dr
Brightwaters, NY 11718
Phone (631) 300-0079

319 E Main St
Patchogue, NY 11772
Phone (631) 300-0797

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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1639866122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 NIMS AVE",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046304",
            "telephone_number": "516-451-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762053",
            "telephone_number": "631-509-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "OSWALDO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351684-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.