Individual provider Active NPI

Terence Galka, PAC

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1083630669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00633 Issued in WI
Practice address
675 W Washington Ave
Madison, WI 53703-2637
Phone
(608) 257-9700
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00633 WI Primary

Addresses

Primary practice location

675 W Washington Ave
Madison, WI 53703-2637

Mailing address

1265 John Q Hammons Dr
Madison, WI 53717-1941
Phone (608) 251-4156

Other identifiers 1

IdentifierTypeStateIssuer
42932800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101222000744 WI Practitioner - Physician Assistant 6901094630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00633WIMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083630669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 JOHN Q HAMMONS DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171941",
            "telephone_number": "608-251-4156",
            "fax_number": "608-257-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032637",
            "telephone_number": "608-257-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALKA",
        "first_name": "TERENCE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "00633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42932800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.