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DR. GWENALYN G. C. GARCIA MD
NPI 1487075024
Internal Medicine - Medical Oncology in Fishersville, VA

Active since December 29, 2013PECOS EnrolledAccepts Medicare Assignment
79.39/100
CMS Quality Rating
57 BEAM LN STE 300, FISHERSVILLE, VA 22939(540) 213-2220(540) 213-2225 Get Directions Write a Review

NPPES record last updated: January 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 2, 2025, Jul 21, 2022, Aug 2, 2021 and 1 more (4 updates tracked since 2017).

About Dr. Gwenalyn G. C. Garcia Md NPPES

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

DR. GWENALYN G. C. GARCIA MD (NPI 1487075024) is an individual medical oncology provider in Fishersville, Virginia, licensed in Virginia (0101272696) and active in the NPI registry since December 2013. She is enrolled in Medicare PECOS, is affiliated with Sentara Rmh Medical Center, and maintains a secondary practice location in Charleston.

NPPES Registry Identity

NPI1487075024
Entity TypeIndividualFemale
Primary Taxonomy207RX0202X
Provider Legal NameDR. GWENALYN G. C. GARCIACredential: MD
Location Address57 BEAM LN STE 300Fishersville, VA 22939-2350
Mailing AddressPo Box 748613Atlanta, GA 30384-8613 · (434) 295-1000
Phone(540) 213-2220
Fax(540) 213-2225
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateDecember 29, 2013
Last NPPES UpdateJanuary 2, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2025
✔ NPI 1487075024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License✔ Licensed in VA · 0101272696
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 27396 (WV)
57 BEAM LN STE 300, Fishersville, VA 22939
Open in Google Maps ↗

Secondary Practice Location 1

Location 13415 MacCorkle Ave SECharleston, WV 25304-1334 · Phone (304) 388-8380 · Fax (304) 388-8395

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

Dr. Gwenalyn G. C. Garcia Md 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 ID6406128834
PECOS Enrollment IDI20210915001453
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

3

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

Uva Community Health Medical Group, LLC
26 mi
Multi-Specialty
4105 LEWIS AND CLARK DR
Charlottesville, VA 22911
  • Reassigned Medicare billing, Virginia enrollment
  • 584 clinicians in this Medicare group
NPI 1598475741 (434) 295-1000
University Of Virginia Physicians Group
26 mi
Neuromusculoskeletal Medicine, Sports Medicine
4105 LEWIS AND CLARK DR
Charlottesville, VA 22911
  • Reassigned Medicare billing, Virginia enrollment
  • 2,820 clinicians in this Medicare group
NPI 1033138250 (434) 295-1000
Charleston Area Medical Center, Inc.
84 mi
Hospitalist
1320 MAPLEWOOD AVE
Ronceverte, WV 24970
  • Reassigned Medicare billing, West Virginia enrollment
  • 1,511 clinicians in this Medicare group
NPI 1972125995 (304) 793-2220

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 6

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 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.
496 services119 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.
476 services204 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.
266 services188 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.
73 services73 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
30 services30 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.
17 services17 patients

Hospital Affiliations CMS Care Compare 3

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

Sentara Rmh Medical Center

Acute Care Hospitals · Harrisonburg, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490004
Location2010 Health Campus DriveHarrisonburg, VA 22801 · Harrisonburg City County
Emergency services Birthing friendly

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number490009
Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County
Emergency services Birthing friendly

Augusta Health

Acute Care Hospitals · Fishersville, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490018
Location78 Medical Center DriveFishersville, VA 22939 · Augusta County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22939 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
$170.30 typical visit price
range $56.19 – $170.30
Typical copayment $42.57 (range $14.04 – $42.57)
Most-billed visit code 99205
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

79.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.66
Promoting Interoperability100
Improvement Activities40
Cost57.65

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
1 supplier34 claims34 services$18.55 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
1 supplier34 claims34 services$35.74 avg. paid by Medicare
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient E0781
DME-Other DME · category DE000N
1 supplier16 claims16 services$196.32 avg. paid by Medicare
Capecitabine, oral, 150 mg J8520
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers11 claims340 services$0.38 avg. paid by Medicare
Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers23 claims1,954 services$0.75 avg. paid by Medicare
Injection, fluorouracil, 500 mg J9190
Treatment-Chemotherapy · category RH002N
1 supplier34 claims396 services$1.68 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

DR. EMANUEL CIRENZA MD
Internal Medicine (Medical Oncology)
57 BEAM LN STE 300
FISHERSVILLE, VA 22939
Augusta County (434) 297-9999
MEERA S KUMAR PA
Nurse Practitioner (Family)
57 BEAM LN STE 300
FISHERSVILLE, VA 22939
Augusta County (540) 213-2220
CORAH L TILLERSON PA
Physician Assistant (Medical)
57 BEAM LN STE 300
FISHERSVILLE, VA 22939
Augusta County (434) 297-9999

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 Gwenalyn Garcia's NPI number?

The NPI number for Gwenalyn Garcia is 1487075024. It was assigned to this individual provider in the NPPES registry on December 29, 2013.

Where is Gwenalyn Garcia located?

Gwenalyn Garcia practices at 57 Beam Ln Ste 300, Fishersville, VA 22939. The listed phone number is (540) 213-2220.

What is Gwenalyn Garcia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Gwenalyn Garcia enrolled in Medicare?

Yes. Gwenalyn 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.

Which organizations bill Medicare for Gwenalyn Garcia's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gwenalyn Garcia reassigns Medicare benefits to 3 organizations: Uva Community Health Medical Group, LLC (Charlottesville, VA), University Of Virginia Physicians Group (Charlottesville, VA) and Charleston Area Medical Center, Inc. (Ronceverte, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gwenalyn Garcia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gwenalyn Garcia accept?

Health plans from Oscar Health list Gwenalyn 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 Gwenalyn Garcia affiliated with any hospitals?

According to CMS data, Gwenalyn Garcia is affiliated with Sentara Rmh Medical Center, University Of Virginia Medical Center and Augusta Health.

When was this NPI record last updated?

The NPPES record for Gwenalyn Garcia was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.