DR. ALEJANDRO GARCIA M.D.
NPI 1073703153
Family Medicine - Sports Medicine in Appleton, WI

Q: What is Alejandro Garcia's NPI number?

The NPI number for Alejandro Garcia is 1073703153. It was assigned to this individual provider in the NPPES registry on July 26, 2007.

Q: What is Alejandro Garcia's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Alejandro Garcia was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 26, 2007PECOS EnrolledAccepts Medicare Assignment

77.77/100

CMS Quality Rating

1531 S MADISON ST, APPLETON, WI 54915(920) 996-3700 Get Directions Write a Review

NPPES record last updated: May 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Alejandro Garcia M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ALEJANDRO GARCIA M.D. (NPI 1073703153) is an individual sports medicine provider in Appleton, Wisconsin, licensed in Wisconsin (54203-020) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Ascension Ne Wisconsin - St Elizabeth Campus, and is a graduate of University Of Puerto Rico School Of Medicine (2007).

NPPES Registry Identity

NPI1073703153

Entity TypeIndividualMale

Primary Taxonomy207QS0010X

Provider Legal NameDR. ALEJANDRO GARCIACredential: M.D.

Location Address1531 S MADISON STAppleton, WI 54915-1800

Mailing Address1531 S Madison StAppleton, WI 54915-1800 · (920) 996-3700

Phone(920) 996-3700

Sole ProprietorNo

Medical School CMSUniversity Of Puerto Rico School Of MedicineGraduated 2007

Enumeration DateJuly 26, 2007

Last NPPES UpdateMay 14, 2021

NPPES CertifiedMay 14, 2021

✔ NPI 1073703153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in WI · 54203-020

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 51582 (MN)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1531 S MADISON ST, Appleton, WI 54915

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Other Identifiers 2

OtherP00764025MN · Medicare Railroad

MedicaidENROLLEDMN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Security Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Alejandro Garcia M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921155417

PECOS Enrollment IDI20110405000911

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg J3304

Triamcinolone acetonide is a long-lasting, preservative-free steroid injection. It's delivered in tiny, slow-releasing particles (microspheres) to manage inflammation or related conditions. The dose given is 1 mg. It's generally safe with few side effects.

3,969 services43 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

1,017 services94 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

261 services114 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

246 services98 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

116 services70 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

47 services25 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

39 services24 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

37 services31 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

28 services28 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services28 patients

Aspiration and/or injection of fluid from small joint using ultrasound guidance 20604

This procedure involves using ultrasound to accurately locate a small joint. A needle is then carefully inserted to remove fluid (aspiration) or inject medication. This can help diagnose or treat joint issues. It's generally safe and minimally invasive.

27 services13 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

22 services17 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

17 services17 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

12 services11 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension NE Wisconsin - St Elizabeth Campus

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520009

Location1506 S Oneida StAppleton, WI 54915 · Outagamie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54915 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.77/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

77.47

Promoting Interoperability

Improvement Activities

Cost

63.8

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

70%460 patients4/55-star benchmark: 92%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

50%439 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

74%806 patients4/55-star benchmark: 85%

Depression Utilization of the PHQ-9 Tool

The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit

Patients 4MonthsOfEnd: 16% · 31 patients

Patients 4MonthsOfStart: 31% · 29 patients

15%27 patients

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

45%125 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

95%231 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

37%889 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%839 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

72%1,633 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

54%1,483 patients3/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

72%1,632 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

24%1,632 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

32%1,632 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAILIE BECK ANPN, FNP-C

Nurse Practitioner (Family)

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 738-2000

MS. MICHELLE KENNEDY COENEN MS

Social Worker (Clinical)

1531 S MADISON ST, STE 550
APPLETON, WI 54915

Calumet County (920) 738-2700

ANNEMARIE UPHUS APNP, PMHNP-BC, CNM

Nurse Practitioner

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 730-4411

DEBRA L. FRANCIOSI APNP

Nurse Practitioner (Psychiatric/Mental Health)

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 730-4411

JENNIFER L CASTRO SAC

Counselor (Addiction (Substance Use Disorder))

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 831-8437

THOMAS G HOEFT D.O.

Orthopaedic Surgery

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 996-3700

CHRISTOPHER W WAGENER MD

Obstetrics & Gynecology

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 730-4413

DR. LEE W HASH M.D.

Orthopaedic Surgery

1531 S MADISON ST
APPLETON, WI 54915

Calumet County (920) 996-3700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alejandro Garcia's NPI number?

The NPI number for Alejandro Garcia is 1073703153. It was assigned to this individual provider in the NPPES registry on July 26, 2007.

Where is Alejandro Garcia located?

Alejandro Garcia practices at 1531 S Madison St, Appleton, WI 54915. The listed phone number is (920) 996-3700.

What is Alejandro Garcia's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Alejandro Garcia enrolled in Medicare?

Yes. Alejandro Garcia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alejandro Garcia accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Security Health Plan list Alejandro Garcia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Alejandro Garcia affiliated with any hospitals?

According to CMS data, Alejandro Garcia is affiliated with Ascension NE Wisconsin - St Elizabeth Campus.

When was this NPI record last updated?

The NPPES record for Alejandro Garcia was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.