STACEY M BOSWELL (PA) – Physician Assistant, NPI 1114268125
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
2,499 PHYSICIAN ASSISTANT in IN
Provider Addresses for STACEY M BOSWELL (PA)
3702 NEW VISION DR
BLDG B
FORT WAYNE, IN 468451703
Phone: (260) 266-8210
Fax: (260) 458-5636
Type: Mailing
2003 STULTS RD
SUITE 120
HUNTINGTON, IN 467501291
Phone: (260) 454-0425
Fax: (260) 355-0299
Type: Location
11141 PARKVIEW PLAZA DR STE 305
FORT WAYNE, IN 468451715
Phone: (260) 266-8900
Fax: (260) 266-8935
Type: Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 468451701
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $55.
Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.
Last reported payment date: 2024-03-12 • Largest payer in this snapshot: Teleflex LLC ($21).
Total Amount
$55
General + Research + Ownership
Payments
3
Total payment records
General Amount
$55
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teleflex LLC | $21 |
| CSL Behring | $20 |
| Ethicon US, LLC | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-06-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130626000753 | I | Physician Assistant | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 15 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 15 | 13 | $0 |
Insurance plans in this area (ZIP 46845)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| Nurse Practitioner | NM | |
| - | IN | |
| Nurse Practitioner | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN | |
| Infectious Disease | IN | |
| Internal Medicine | IN | |
| - | IN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.