Individual provider Active NPI

Melanie L Pequignot, PA

  • Physician Assistant
  • Fort Wayne, IN
National Provider Identifier
1093037798
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001156 Issued in IN
Practice address
7910 W Jefferson Blvd Ste 110
Fort Wayne, IN 46804-4159
Phone
(260) 436-4116
Fax
(260) 436-1878
NPI assigned
Feb 22, 2010
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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 10001156 IN Primary

Addresses

Primary practice location

7910 W Jefferson Blvd Ste 110
Fort Wayne, IN 46804-4159

Mailing address

7910 W Jefferson Blvd Ste 110
Fort Wayne, IN 46804-4159
Phone (260) 436-4116

Other practice location 1

10307 DuPont Circle Dr W Ste B
Fort Wayne, IN 46825-1633
Phone (260) 818-7001

Other names 1

  • Melanie L Millikan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100322000571 IN Practitioner - Physician Assistant 9931234531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiation Oncology Associates P CGroup PAC ID 8527041771, 9 clinicians

Practice addresses (Care Compare)

1520 Provident Dr
Warsaw, IN 46580-3291
Phone (574) 372-3800

7910 W Jefferson Blvd
Suite 110
Fort Wayne, IN 46804-4159
Phone (260) 436-4116

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001156INMDPhysician 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1093037798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-436-4116",
            "fax_number": "260-436-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-436-4116",
            "fax_number": "260-436-1878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10307 DuPont Circle Dr W Ste B",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251633",
            "country_code": "US",
            "telephone_number": "260-818-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEQUIGNOT",
        "first_name": "MELANIE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-22",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "MILLIKAN",
            "middle_name": "L",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.