Individual provider Active NPI

Clarinda J Garcia, PA-C

  • Medical Physician Assistant
  • Pueblo of Acoma, NM
National Provider Identifier
1669427852
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02418 Issued in TX
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, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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 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

IdentifierTypeStateIssuer
PA02418OtherTXLICENSE NUMBER
H3451MedicaidNM

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

LicenseStateTypeSpecialty
PA02418TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Acoma-Canoncito-Laguna Indian Health Center Past Accepting new patients
Gary W. Elam, MD, PA PastSince Aug 1, 2000 Accepting new patients
MCH Professional Care PastSince Jan 25, 2017 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.

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.

Verify at the official NPI Registry.