Individual provider Active NPI

Evanthia Garza, PA

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1871967372
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone
(919) 589-1204
Fax
(919) 589-1264
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 Primary

Addresses

Primary practice location

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462

Mailing address

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone (919) 589-1204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160223002123 NC Practitioner - Physician Assistant 4789989104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Wellness Behavioral HealthGroup PAC ID 6507244498, 8 clinicians

Practice addresses (Care Compare)

613 Maywood Ave
Raleigh, NC 27603-2339
Phone (919) 582-6776

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: evanthia.garza@direct.medpsych.nchie.net

Organizations & group practices 1

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1871967372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "EVANTHIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.