Individual provider Active NPI

Michael A Garcia, PA-C

  • Physician Assistant
  • Antioch, CA
National Provider Identifier
1740567627
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21967 Issued in CA
Practice address
3901 Lone Tree Way
Antioch, CA 94509-6200
Phone
(925) 779-7200
Fax
(925) 779-3006
NPI assigned
Nov 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21967 CA Primary

Addresses

Primary practice location

3901 Lone Tree Way
Antioch, CA 94509-6200

Mailing address

1854 Buck Mountain CT
Antioch, CA 94531-9098
Phone (415) 710-6894

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111215000939 CA Practitioner - Physician Assistant 1456526698 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA21967CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Nov 1, 2016 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Nov 1, 2016 Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients

Locations

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (925) 244-9355

6001 Norris Canyon Rd
San Ramon, CA 94583
Phone (925) 275-8273

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

Organizations & group practices 3

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": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1740567627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1854 BUCK MOUNTAIN CT",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319098",
            "telephone_number": "415-710-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096200",
            "telephone_number": "925-779-7200",
            "fax_number": "925-779-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-07",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.