MR. JOSE L GARCIA III CRNA
NPI 1003314279
Nurse Anesthetist, Certified Registered in Harlingen, TX

NPI Status: Active since January 23, 2018

Contact Information

2101 PEASE ST
HARLINGEN, TX
ZIP 78550
Phone: (956) 867-2530

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 9
Nurse Anesthetist, Certified Registered
Accepts Insurance
Accepts Medicare Approved Payment
Medicare Quality Reporting

About JOSE GARCIA

This page provides the complete NPI Profile along with additional information for Jose Garcia, a provider established in Harlingen, Texas with a medical specialization in Nurse Anesthetist, Certified Registered and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1003314279 assigned on January 2018. The practitioner's primary taxonomy code is 367500000X with license number AP136259 (TX). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI: 1003314279
Provider Name: MR. JOSE L GARCIA III CRNA
Other Name: MR. TREY GARCIA CRNA
Other Name Type: Other Name (5)
Gender: Male
Entity Type: Individual
Location Address: 2101 PEASE ST HARLINGEN, TX 78550
Location Phone: (956) 867-2530
Mailing Address: 1702 N ED CAREY DR HARLINGEN, TX 78550
Medical School Name: OTHER
Graduation Year: 2017
Is Sole Proprietor?: Yes
Enumeration Date: 01-23-2018
Last Update Date: 01-23-2018
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Anesthetist, Certified Registered
Taxonomy Code: 367500000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: AP136259
License State: TX
Taxonomy Description: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204 - HMO
Blue Advantage Bronze HMO? 301 - HMO
Blue Advantage Bronze HMO? Standard - HMO
Blue Advantage Gold HMO? 206 - HMO
Blue Advantage Gold HMO? 603 - HMO
Blue Advantage Gold HMO? Standard - HMO
Blue Advantage Plus Bronze? 303 - POS
Blue Advantage Plus Bronze? 305 - POS
Blue Advantage Plus Bronze? Standard - POS
Blue Advantage Plus Gold? 203 - POS
Blue Advantage Plus Gold? 803 - POS
Blue Advantage Plus Gold? Standard - POS
Blue Advantage Plus Silver? 202 - POS
Blue Advantage Plus Silver? 605 - POS
Blue Advantage Plus Silver? Standard - POS
Blue Advantage Security HMO? 200 - HMO
Blue Advantage Silver HMO? 205 - HMO
Blue Advantage Silver HMO? 801 - HMO
Blue Advantage Silver HMO? Standard - HMO
MyBlue Health Bronze? 402 - HMO

Molina Healthcare

Gold 1 - HMO
Gold 1 with Adult Vision Services - HMO
Gold 12 - HMO
Gold 8 - HMO
Silver 1 - HMO
Silver 1 with Adult Vision Services - HMO
Silver 12 with First 4 Primary Care Visits Free - HMO
Silver 8 - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jose Garcia is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

PECOS PAC ID: 9638431455
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20180314002195
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Anesthesia for procedure for total knee joint replacement

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $17.13 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 78550 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $126.4
Minimum New Patient Price $54.84
Maximum New Patient Price $166.88

Average New Patient Copayment $31.6
Minimum New Patient Copayment $13.71
Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $68.55
Minimum Established Patient Price $17.52
Maximum Established Patient Price $136.11

Average Established Patient Copayment $17.13
Minimum Established Patient Copayment $4.38
Maximum Established Patient Copayment $34.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Participation in an AHRQ-listed patient safety organization.	Yes	N/A
Participation in an AHRQ-listed patient safety organization.
Pre-operative OSA assessment	100%	631
Percentage of patients who undergo a surgical procedure in the operating room/procedure room that have a pre-operative assessment for Obstructive Sleep Apnea (OSA)
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Use of QCDR data for quality improvement such as comparative analysis reports across patient populations	Yes	N/A
Participation in a QCDR, clinical data registries, or other registries run by other government agencies such as FDA, or private entities such as a hospital or medical or surgical society. Activity must include use of QCDR data for quality improvement (e.g., comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcome).
Use of QCDR for feedback reports that incorporate population health	Yes	N/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.
Use of QCDR to support clinical decision making	Yes	N/A
Participation in a QCDR, demonstrating performance of activities that promote implementation of shared clinical decision making capabilities.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jose Garcia is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
CORNERSTONE REGIONAL HOSPITAL	2302 CORNERSTONE BOULEVARD EDINBURG, TX 78539	(956) 618-4444	Acute Care Hospitals

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	0	0	3	3	1	4	2	7	9
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	0	0	3	6	1	8	2	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 6 + 1 + 8 + 2 + 1 + 4 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 9									9

The NPI number 1003314279 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 19 providers are registered at the same or nearby location.

MARK M HAYDEN MD

Emergency Medicine

(Emergency Medical Services)

2101 PEASE ST
HARLINGEN, TX
ZIP 78550

About JOSE GARCIA

Location Map

Specialty - Primary Taxonomy

Nurse Anesthetist, Certified Registered

Insurance Plans Accepted

Medicare Participation & PECOS Enrollment Status

PECOS PAC ID: 9638431455

PECOS Enrollment ID: I20180314002195

Accepts Medicare Assignment? Yes

Areas of Expertise

Anesthesia for procedure for total knee joint replacement