Individual provider Active NPI

Evangeline M Garcia, MD

  • Psychiatry Physician
  • Cambridge, MD
National Provider Identifier
1861488058
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0018661 Issued in MD
Practice address
813 Chesapeake Dr Ste 1
Cambridge, MD 21613
Phone
(410) 221-2266
Fax
(410) 221-2878
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X D0018661 MD
Psychiatry Physician 2084P0800X D0018661 MD Primary

Addresses

Primary practice location

813 Chesapeake Dr Ste 1
Cambridge, MD 21613

Mailing address

813 Chesapeake Dr Ste 1
Cambridge, MD 21613-9405
Phone (410) 221-2266

Other practice location 1

828 Airpax Rd
Suite 300B
Cambridge, MD 21613-6405
Phone (410) 228-3929

Other identifiers 2

IdentifierTypeStateIssuer
479302100MedicaidMD
774800100MedicaidMD

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0018661MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jani Associates, LLC PastSince Jun 26, 2012 Accepting new patients
Choices Family Services, LLC Past Accepting new patients
Maryland Addictions & Psych Inc Past Accepting new patients

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1861488058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 CHESAPEAKE DR STE 1",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216139405",
            "telephone_number": "410-221-2266",
            "fax_number": "410-221-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 CHESAPEAKE DR STE 1",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "21613",
            "telephone_number": "410-221-2266",
            "fax_number": "410-221-2878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "828 Airpax Rd",
            "address_2": "Suite 300B",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MD",
            "postal_code": "216136405",
            "country_code": "US",
            "telephone_number": "410-228-3929",
            "fax_number": "410-228-3810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "EVANGELINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0018661",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0018661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479302100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774800100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.