SAMUEL ANTONIO GALICIA M.D.
NPI 1104238104
Internal Medicine in Manteca, CA

Q: What is Samuel Galicia's NPI number?

The NPI number for Samuel Galicia is 1104238104. It was assigned to this individual provider in the NPPES registry on May 24, 2014.

Q: What is Samuel Galicia's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Galicia was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 May 24, 2014PECOS EnrolledAccepts Medicare Assignment

1721 W YOSEMITE AVE, MANTECA, CA 95337(209) 825-3700 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 17, 2021, Mar 17, 2018, Oct 22, 2017 (3 updates tracked since 2017).

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About Samuel Antonio Galicia M.d. NPPES

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

SAMUEL ANTONIO GALICIA M.D. (NPI 1104238104) is an individual internal medicine provider in Manteca, California, licensed in California (A145065) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in New Rochelle, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1104238104

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSAMUEL ANTONIO GALICIACredential: M.D.

Location Address1721 W YOSEMITE AVEManteca, CA 95337-5130

Mailing Address1721 W Yosemite AveManteca, CA 95337-5130 · (209) 825-3700

Phone(209) 825-3700

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateMay 24, 2014

Last NPPES UpdateDecember 17, 20213 updates tracked since enumeration

NPPES CertifiedDecember 17, 2021

✔ NPI 1104238104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A145065

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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

1721 W YOSEMITE AVE, Manteca, CA 95337

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Secondary Practice Location 1

Location 116 Guion PlNew Rochelle, NY 10801-5502 · Phone (914) 365-3680

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

Samuel Antonio Galicia 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 ID9830457175

PECOS Enrollment IDI20171214002514

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95337 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

$133.94 typical visit price

range $58.87 – $176.60

Typical copayment $33.48 (range $14.71 – $44.15)

Most-billed visit code 99204

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

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.

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.

ALEXANDER PAIZ

Physical Therapist