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CAROL BURZON GALICIA PA
NPI 1609686112
Physician Assistant in Fort Wayne, IN

Active since January 08, 2025PECOS EnrolledAccepts Medicare Assignment
3919 W JEFFERSON BLVD STE 2, FORT WAYNE, IN 46804(260) 436-7722(260) 459-0012 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carol Burzon Galicia Pa NPPES

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

CAROL BURZON GALICIA PA (NPI 1609686112) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10004703A) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1609686112
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCAROL BURZON GALICIACredential: PA
Location Address3919 W JEFFERSON BLVD STE 2Fort Wayne, IN 46804-6811
Mailing Address3919 W Jefferson Blvd Ste 2Fort Wayne, IN 46804-6811 · (260) 436-7722 · Fax (260) 459-0012
Phone(260) 436-7722
Fax(260) 459-0012
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 8, 2025
NPPES CertifiedJanuary 8, 2025
✔ NPI 1609686112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IN · 10004703A
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3919 W JEFFERSON BLVD STE 2, Fort Wayne, IN 46804
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Carol Burzon Galicia Pa 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 ID2264960301
PECOS Enrollment IDI20250116002631
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 46804 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

Other Providers at the Same Location NPPES 2

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

SAVANNAH E. PLATT NP
Nurse Practitioner (Family)
3919 W JEFFERSON BLVD STE 2
FORT WAYNE, IN 46804
Allen County (260) 436-7722
JANY PEREZ PEDRAZA ARNP
Nurse Practitioner (Family)
3919 W JEFFERSON BLVD STE 2
FORT WAYNE, IN 46804
Allen County (260) 450-1313

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 Carol Galicia's NPI number?

The NPI number for Carol Galicia is 1609686112. It was assigned to this individual provider in the NPPES registry on January 8, 2025.

Where is Carol Galicia located?

Carol Galicia practices at 3919 W Jefferson Blvd Ste 2, Fort Wayne, IN 46804. The listed phone number is (260) 436-7722.

What is Carol Galicia's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Carol Galicia enrolled in Medicare?

Yes. Carol Galicia 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 Carol Galicia accept?

Health plans from CareSource list Carol Galicia 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 Carol Galicia was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.