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DR. CAROLYN LOUISE GARCIA M.D.
NPI 1871571349
Obstetrics & Gynecology in Herndon, VA

Active since January 05, 2006PECOS EnrolledAccepts Medicare Assignment
1141 ELDEN ST STE 300, HERNDON, VA 20170(703) 443-2000 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 9, 2022, Mar 17, 2018, May 30, 2017 (3 updates tracked since 2017).

About Dr. Carolyn Louise Garcia M.d. NPPES

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

DR. CAROLYN LOUISE GARCIA M.D. (NPI 1871571349) is an individual obstetrics & gynecology provider in Herndon, Virginia, licensed in Virginia (010127440) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1871571349
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. CAROLYN LOUISE GARCIACredential: M.D.
Location Address1141 ELDEN ST STE 300Herndon, VA 20170-5572
Mailing Address350 South 40th StreetMuskogee, OK 74401-4915 · (918) 683-0753 · Fax (866) 397-7556
Phone(703) 443-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJanuary 5, 2006
Last NPPES UpdateMay 9, 20223 updates tracked since enumeration
NPPES CertifiedMay 9, 2022
✔ NPI 1871571349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in VA · 010127440✔ Licensed in OK · 29561
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1141 ELDEN ST STE 300, Herndon, VA 20170
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11202 W Cherokee St Ste GWagoner, OK 74467-4629 · Phone (918) 201-7019 · Fax (918) 201-7022
Location 2350 S 40th StMuskogee, OK 74401-4915 · Phone (918) 683-0753 · Fax (866) 397-7556

Other Identifiers 2

Medicaid200462080AOK
Medicaid200468380XOK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.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. Carolyn Louise 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 ID4082799028
PECOS Enrollment IDI20130404000123, I20241101001705
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 20170 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
90%258 patients4/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
4%184 patients1/55-star benchmark: 100%
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)…
97%359 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
41%274 patients2/55-star benchmark: 85%
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
49%100 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.
99%1,651 patients5/55-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…
44%184 patients3/55-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.
97%470 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.
62%634 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…
21%611 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
33%507 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 97% · 505 patients
Patients tobacco: 11% · 54 patients
77%505 patients4/55-star benchmark: 98%
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…
80%634 patients4/55-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…
12%634 patients1/55-star benchmark: 89%
Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months
56%57 patients
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.
22%634 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

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

MONIQUE CHINYERE NWALA MPAS, PA-C
Physician Assistant
1141 ELDEN ST STE 300
HERNDON, VA 20170
Fairfax County (703) 840-4705

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 Carolyn Garcia's NPI number?

The NPI number for Carolyn Garcia is 1871571349. It was assigned to this individual provider in the NPPES registry on January 5, 2006.

Where is Carolyn Garcia located?

Carolyn Garcia practices at 1141 Elden St Ste 300, Herndon, VA 20170. The listed phone number is (703) 443-2000.

What is Carolyn Garcia's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Carolyn Garcia enrolled in Medicare?

Yes. Carolyn 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 Carolyn Garcia accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Carolyn 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.

When was this NPI record last updated?

The NPPES record for Carolyn Garcia was last updated on May 9, 2022. 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.