Individual provider Active NPI

Johanny Magnolia Garcia, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1679628432
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220467 Issued in NY
Practice address
5141 Broadway
New York, NY 10034-1159
Phone
(212) 932-4439
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220467 NY Primary

Addresses

Primary practice location

5141 Broadway
New York, NY 10034-1159

Mailing address

630 W 168TH St # 4
VC 12TH Floor, Suite 208
New York, NY 10032-3725

Other identifiers 1

IdentifierTypeStateIssuer
02168610MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109000559 NJ Practitioner - Internal Medicine 4183616931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Internal Medicine CurrentSince Oct 28, 2023 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients
The New York and Presbyterian Hospital Internal Medicine Past Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

201 Lyons Ave
#L4
Newark, NJ 07112
Phone (973) 926-7154

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jgarcia6484083@nychhc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1679628432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "address_2": "VC 12TH FLOOR, SUITE 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5141 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341159",
            "telephone_number": "212-932-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JOHANNY",
        "middle_name": "MAGNOLIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02168610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.