ERIKA GARCIA APN
NPI 1366018475
Nurse Practitioner - Family in Dumont, NJ

Q: What is Erika Garcia's NPI number?

The NPI number for Erika Garcia is 1366018475. It was assigned to this individual provider in the NPPES registry on May 29, 2021.

Q: What is Erika Garcia's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Erika Garcia was last updated on May 29, 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 May 29, 2021PECOS EnrolledAccepts Medicare Assignment

98.67/100

CMS Quality Rating

40 WASHINGTON AVE, DUMONT, NJ 07628(201) 387-7055(201) 387-8605 Get Directions Write a Review

NPPES record last updated: May 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Erika Garcia Apn NPPES

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

ERIKA GARCIA APN (NPI 1366018475) is an individual family provider in Dumont, New Jersey, licensed in New Jersey (26NJ01155800) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, is affiliated with Valley Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1366018475

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameERIKA GARCIACredential: APN

Location Address40 WASHINGTON AVEDumont, NJ 07628-3697

Mailing Address40 Washington AveDumont, NJ 07628-3697 · (201) 387-7055 · Fax (201) 387-8605

Phone(201) 387-7055

Fax(201) 387-8605

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 29, 2021

NPPES CertifiedMay 29, 2021

✔ NPI 1366018475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NJ · 26NJ01155800

40 WASHINGTON AVE, Dumont, NJ 07628

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Erika Garcia Apn 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 ID5799181905

PECOS Enrollment IDI20210913002322

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.

Medicare Billing Reassignments

Medicare enrollment records show Erika Garcia reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Valley Physician Services PC

4.4 mi

Internal Medicine

15 ESSEX RD
Paramus, NJ 07652

Reassigned Medicare billing, New Jersey enrollment
833 clinicians in this Medicare group

NPI 1467815928 (201) 291-6086

Prohealth Urgent Care Medicine Of New Jersey LLP

8.7 mi

Emergency Care

461 RIVER RD
Edgewater, NJ 07020

Reassigned Medicare billing, New Jersey enrollment
144 clinicians in this Medicare group

NPI 1477927754 (516) 622-6000

Urgent Care Physicians Of New Jersey, LLC

41 mi

Emergency Medicine

46 NEWMAN SPRINGS RD E STE F
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
160 clinicians in this Medicare group

NPI 1447622402 (973) 630-8947

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

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.

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.

256 services175 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

214 services130 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.

101 services83 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

88 services88 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

41 services41 patients

Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected 0241U

This test detects the RNA of respiratory viruses, including COVID-19, Influenza A, Influenza B, and Respiratory Syncytial Virus, in an upper respiratory specimen. The test result will report if each virus is detected or not, helping in accurate diagnosis.

39 services37 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

37 services36 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

36 services36 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

36 services36 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

29 services26 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

19 services19 patients

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique 87651

This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.

18 services17 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

16 services15 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

15 services14 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

12 services12 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Valley Hospital

Acute Care Hospitals · Paramus, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310012

Location4 Valley Health PlazaParamus, NJ 07652 · Bergen County

Emergency services Birthing friendly

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Englewood Hospital And Medical Center

Acute Care Hospitals · Englewood, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310045

Location350 Engle StEnglewood, NJ 07631 · Bergen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07628 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

98.67/100

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

Scored through an Alternative Payment Model

Quality

93.57

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 8

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

DR. PHILIPPE DESPLAT D.O.

Family Medicine

40 WASHINGTON AVE, VALLEY HEALTH MEDICAL GROUP
DUMONT, NJ 07628

Bergen County (201) 387-7055

DR. SEENA SHEKARI D.O.

Family Medicine