ANDREW M. GALICA M.D.
NPI 1881057198
Psychiatry & Neurology - Neurology in Worcester, MA

Active since April 04, 2016PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1000 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 16, 2023, Jul 15, 2022 (2 updates tracked since 2022).

About Andrew M. Galica M.d. NPPES

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

ANDREW M. GALICA M.D. (NPI 1881057198) is an individual neurology provider in Worcester, Massachusetts, licensed in Massachusetts (292083) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Massachusetts Medical School (2016).

NPPES Registry Identity

NPI1881057198
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameANDREW M. GALICACredential: M.D.
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2016
Enumeration DateApril 4, 2016
Last NPPES UpdateMay 16, 20232 updates tracked since enumeration
NPPES CertifiedMay 16, 2023
✔ NPI 1881057198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in MA · 292083
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · Brain Injury MedicineTaxonomy 2084P0301X · License 292083 (MA)
55 LAKE AVE N, Worcester, MA 01655

Accepted 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

Andrew M. Galica 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 ID6204128226
PECOS Enrollment IDI20220802000636
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 Reassignment

Medicare enrollment records show Andrew Galica reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Internal Medicine
55 LAKE AVE N
Worcester, MA 01655
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2,902 clinicians in this Medicare group

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 10

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
83 services83 patients
Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle 95874
This procedure involves a needle that measures the electrical activity in your muscles. A chemical is then injected to temporarily paralyze the nerve muscle. This helps in diagnosing and treating certain muscle or nerve conditions.
78 services26 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.
58 services45 patients
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity 64643
This procedure involves injecting a special chemical into 1-4 muscles in an arm or leg to temporarily paralyze them. This can help manage pain or muscle disorders. If needed, the process can be repeated on an additional limb.
46 services15 patients
Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity 64644
This procedure involves injecting a chemical into specific muscles in an arm or leg to temporarily paralyze them. It's typically used to manage muscular disorders or reduce muscle activity. The process targets 5 or more muscles in the first extremity.
40 services14 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.
40 services34 patients

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Worcester, MA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number220176
Location123 Summer StreetWorcester, MA 01608 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

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 Andrew Galica's NPI number?

The NPI number for Andrew Galica is 1881057198. It was assigned to this individual provider in the NPPES registry on April 4, 2016.

Where is Andrew Galica located?

Andrew Galica practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-1000.

What is Andrew Galica's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Andrew Galica enrolled in Medicare?

Yes. Andrew Galica 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 organization bills Medicare for Andrew Galica's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Galica reassigns Medicare benefits to Umass Memorial Medical Group Inc (Worcester, MA). The 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 Andrew Galica's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrew Galica accept?

Health plans from Anthem Blue Cross and Blue Shield list Andrew Galica 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 Andrew Galica affiliated with any hospitals?

According to CMS data, Andrew Galica is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Medical Center/University Campus and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Galica was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.