Active NPI
Clarinda J Garcia, PA-C
- Medical Physician Assistant
- Pueblo of Acoma, NM
National Provider Identifier
1669427852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA02418
- Practice address
- 80 B Veterans Blvd
Pueblo of Acoma, NM 87034 - Phone
- (505) 552-5300
- Fax
- (505) 552-5490
- NPI assigned
- May 24, 2006
- Last updated
- Mar 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA02418 | TX | Primary |
Addresses
Primary practice location
80 B Veterans Blvd
Pueblo of Acoma, NM 87034
Mailing address
PO Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA02418 | Other | TX | LICENSE NUMBER |
| H3451 | Medicaid | NM |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02418 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acoma-Canoncito-Laguna Indian Health Center | Past | Accepting new patients | |
| Gary W. Elam, MD, PA | Past | Accepting new patients | |
| MCH Professional Care | Past | Accepting new patients | |
| Haaku Health | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Health Service Clinic/Center
- Acoma, NM
- NPI 1225103922
-
- Health Service Clinic/Center
- San Fidel, NM
- NPI 1962384438
-
- Otolaryngology Physician
- Odessa, TX
- NPI 1255421152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520899200000",
"number": "1669427852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "870490130",
"telephone_number": "505-552-5300",
"fax_number": "505-552-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 B VETERANS BLVD",
"city": "PUEBLO OF ACOMA",
"state": "NM",
"postal_code": "87034",
"telephone_number": "505-552-5300",
"fax_number": "505-552-5490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "CLARINDA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2018-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA02418",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PA02418",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H3451",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo of Acoma, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.