DR. RONALD A GARCIA MD
NPI 1871678060
Physical Medicine & Rehabilitation in Janesville, WI

NPI Status: Active since October 26, 2006

Contact Information

557 N WASHINGTON ST
JANESVILLE, WI
ZIP 53548
Phone: (608) 754-6000

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  • Individual
  • Male
  • Years of Experience 34
  • Physical Medicine & Rehabilitation
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RONALD GARCIA

This page provides the complete NPI Profile along with additional information for Ronald Garcia, a provider established in Janesville, Wisconsin with a medical specialization in Physical Medicine & Rehabilitation and more than 34 years of experience. The healthcare provider is registered in the NPI registry with number 1871678060 assigned on October 2006. The practitioner's primary taxonomy code is 208100000X with license number 43720 (WI). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1871678060
Provider Name
DR. RONALD A GARCIA MD
Gender
Male
Entity Type
Individual
Location Address
557 N WASHINGTON ST JANESVILLE, WI 53548
Location Phone
(608) 754-6000
Mailing Address
557 N WASHINGTON ST JANESVILLE, WI 53548
Mailing Phone
(608) 754-6000
Medical School Name
OTHER
Graduation Year
1992
Is Sole Proprietor?
No
Enumeration Date
10-26-2006
Last Update Date
07-08-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
43720
License State
WI
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208100000XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation

(IL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • MercyCare Bronze 10,000 (1 Free PCP Visit) - HMO
  • MercyCare Bronze Standard Expanded - HMO
  • MercyCare Gold Standard - HMO
  • MercyCare Silver 2,500 (3 Free PCP Visits) - HMO
  • MercyCare Silver Health Savings - HMO
  • MercyCare Silver Standard - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
34133500MEDICAID (05)WI 
H47498MEDICARE UPIN (02) 

Medicare Participation & PECOS Enrollment Status

Ronald Garcia is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Ronald Garcia is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4183684178

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20041014000074

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

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

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.

This service was performed 56 times for 32 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 38 times for 36 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 85 times for 63 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 68 times for 43 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 245 times for 144 patients

Nerve conduction, 3-4 studies

Nerve conduction studies are tests that measure how well your nerves are working. In a 3-4 studies procedure, electrical signals are sent through 3-4 nerves. The speed and strength of the signal's travel is recorded to detect any nerve damage or dysfunction.

This service was performed 54 times for 54 patients

Nerve conduction, 7-8 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps doctors identify nerve damage. In a 7-8 study procedure, 7-8 specific nerves are tested. You may feel a mild, brief tingling or shock during the test.

This service was performed 75 times for 74 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 79 times for 79 patients

New patient office or other outpatient visit, 30-44 minutes

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.

This service was performed 11 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 103 times for 103 patients

Ultrasonic guidance for needle placement

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.

This service was performed 70 times for 48 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ronald Garcia is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MERCY HEALTH SYSTEM CORP1000 MINERAL POINT AVE
JANESVILLE, WI 53548
(608) 756-6080Acute Care Hospitals
MERCY WALWORTH HOSPITAL & MEDICAL CENTERN2950 STATE ROAD 67
LAKE GENEVA, WI 53147
(262) 245-0535Critical Access Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1871678060, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
1
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
7
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 6 → 12 → 3 8 → 16 → 7 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 4 + 1 + 1 + 2 + 7 + 1 + 6 + 0 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1871678060.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Occupational Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Orthopaedic Surgery (Hand Surgery)
557 N WASHINGTON ST
JANESVILLE, WI 53548
Family Medicine (Sports Medicine)
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Specialist/Technologist (Athletic Trainer)
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapy Assistant
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548
Physical Therapist
557 N WASHINGTON ST
JANESVILLE, WI 53548

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1871678060, enumerated as an "individual" on October 26, 2006.

The provider is located at 557 N WASHINGTON ST JANESVILLE, WI 53548 and the phone number is (608) 754-6000.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, MercyCare. Please consult your insurance carrier or call the provider to verify.

Ronald Garcia is affiliated with: MERCY HEALTH SYSTEM CORP and MERCY WALWORTH HOSPITAL & MEDICAL CENTER.