Individual provider Active NPI

Michele Marie Garcia, PA-C

  • Physician Assistant
  • Saint Cloud, MN
National Provider Identifier
1669455242
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9371 Issued in MN
Practice address
2420 W Division St
Saint Cloud, MN 56301-3926
Phone
(320) 253-5366
NPI assigned
Nov 28, 2005
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9371 MN Primary
Family Medicine Physician 207Q00000X 9371 MN

Addresses

Primary practice location

2420 W Division St
Saint Cloud, MN 56301-3926

Mailing address

2420 West Division Street
CVS Minuteclinic
St Cloud, MN 56301-3926
Phone (320) 253-5366

Other practice location 1

161 Glen Street #101
CentraCare Quick Clinic Foley
Foley, MN 56329
Phone (320) 656-7128

Other identifiers 1

IdentifierTypeStateIssuer
413292100MedicaidMN

Other names 1

  • Michele M McNaughton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050301000016 MN Practitioner - Physician Assistant 0749233955 Reassigns benefits to 1 organization
I20250417000980 MI Practitioner - Physician Assistant 0749233955 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Past Accepting new patients
Catalyst Medical Clinic PA PastSince Jan 29, 2001 Accepting new patients
Premier OBGYN of Minnesota PLLC Past Accepting new patients
Central Minnesota Neurosciences LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mgarcia382590@direct.centracare.com
  • Direct secure messaging: michele.garcia.1@26566.direct.athenahealth.com
  • Direct secure messaging: michele.garcia.2@26566.direct.athenahealth.com

Organizations & group practices 5

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1669455242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 WEST DIVISION STREET",
            "address_2": "CVS MINUTECLINIC",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563013926",
            "telephone_number": "320-253-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W DIVISION ST",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013926",
            "telephone_number": "320-253-5366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Glen Street #101",
            "address_2": "CentraCare Quick Clinic Foley",
            "address_purpose": "LOCATION",
            "city": "Foley",
            "state": "MN",
            "postal_code": "56329",
            "country_code": "US",
            "telephone_number": "320-656-7128",
            "fax_number": "763-241-7338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9371",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "9371",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413292100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "MCNAUGHTON",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.