Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carol Burzon Galicia, PA

Individual provider Physician Assistant · NPI 1609686112

Carol Burzon Galicia, PA is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2024, 2 years ago. Practices with Jefferson Park Pediatrics P C, a 4-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3919 W Jefferson Blvd Ste 2
Fort Wayne, IN 46804-6811
Phone: (260) 436-7722
Fax: (260) 459-0012
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10004703A (IN)

Record details

NPI number1609686112
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 8, 2025
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Jefferson Park Pediatrics P C — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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