MELINDA PEISERICH (PA-C) – Physician Assistant, NPI 1962011684

MELINDA PEISERICH (PA-C) is a healthcare provider. based in Fort wayne, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 10003230A (IN). The NPI Number for MELINDA PEISERICH (PA-C) is 1962011684

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
MELINDA PEISERICH (PA-C)
NPI
1962011684
Phone
(260) 249-5457
Address
15332 BRISTLECONE CT
Enumeration Date
28 July 2020
Last Update Date
23 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
0941601298
Group Practice PAC ID
3476533324
Professional Enrollment ID
I20220827000459
Address ID
MI490368449CO142XXAXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

2,499 PHYSICIAN ASSISTANT in IN

Provider Addresses for MELINDA PEISERICH (PA-C)

  • 15332 BRISTLECONE CT

    FORT WAYNE, IN 468149468

    Phone: (260) 249-5457

    Type: Mailing

  • 1819 CAREW ST

    FORT WAYNE, IN 468054705

    Phone: (260) 702-8055

    Type: Location

  • 7900 W JEFFERSON BLVD STE 306

    FORT WAYNE, IN 468044128

    Phone: (260) 458-3610

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $65.

Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.

Last reported payment date: 2023-04-01 • Largest payer in this snapshot: ABBVIE INC. ($51).

Total Amount

$65

General + Research + Ownership

Payments

3

Total payment records

General Amount

$65

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-01

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-08-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210624001983IPhysician AssistantINTBD
I20220827000459IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes271209$0
99213Established patient office or other outpatient visit, 20-29 minutes238194$0
99212Established patient office or other outpatient visit, 10-19 minutes144123$0
92083Exam of visual field with extended testing132132$0
J9035Injection, bevacizumab, 10 mg7932$0
View full utilization report →

Insurance plans in this area (ZIP 46814)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476533324View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P H T H A L M O L O G YIN
O P H T H A L M O L O G YMI

Reviews

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Frequently asked questions

How do payers reference MELINDA PEISERICH (PA-C)?
For MELINDA PEISERICH (PA-C), use NPI 1962011684 as the unique 10-digit identifier.
Would MELINDA PEISERICH (PA-C) appear as active to a payer?
You can treat MELINDA PEISERICH (PA-C) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe MELINDA PEISERICH (PA-C)'s focus?
For MELINDA PEISERICH (PA-C), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Indiana is MELINDA PEISERICH (PA-C) registered?
Use Fort Wayne, Indiana as the headline location for MELINDA PEISERICH (PA-C) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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