Active NPI
Mario Oscar Garcia Incera, PA
- Physician Assistant
- Juana Diaz, PR
National Provider Identifier
1821780743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2265-PA
- Practice address
- Juana Diaz
Juana Diaz, PR 00795 - Phone
- (787) 649-1987
- NPI assigned
- May 22, 2023
- Last updated
- Dec 5, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2265-PA | PR | Primary |
Addresses
Primary practice location
Juana Diaz
Juana Diaz, PR 00795
Mailing address
Colinas del Prado
1 Calle Rey Eduardo
Juana Diaz, PR 00795
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2265-PA | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1821780743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "COLINAS DEL PRADO",
"address_2": "1 CALLE REY EDUARDO",
"city": "JUANA DIAZ",
"state": "PR",
"postal_code": "00795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JUANA DIAZ",
"city": "JUANA DIAZ",
"state": "PR",
"postal_code": "00795",
"telephone_number": "787-649-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA INCERA",
"first_name": "MARIO",
"middle_name": "OSCAR",
"name_prefix": "Dr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-22",
"last_updated": "2024-12-05",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "2265-PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Juana Diaz, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.