JEFFREY PAUL LICATA PA-C
NPI 1104385947
Physician Assistant - Medical in Staten Island, NY

Q: What is Jeffrey Licata's NPI number?

The NPI number for Jeffrey Licata is 1104385947. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Q: What is Jeffrey Licata's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jeffrey Licata was last updated on December 19, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 19, 2019PECOS EnrolledAccepts Medicare Assignment

98.65/100

CMS Quality Rating

3333 HYLAN BLVD, STATEN ISLAND, NY 10306(718) 667-7500 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jeffrey Paul Licata Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY PAUL LICATA PA-C (NPI 1104385947) is an individual medical provider in Staten Island, New York, licensed in New York (031134) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tinton Falls, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1104385947

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameJEFFREY PAUL LICATACredential: PA-C

Location Address3333 HYLAN BLVDStaten Island, NY 10306-3608

Mailing Address3333 Hylan BlvdStaten Island, NY 10306-3608

Phone(718) 667-7500

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMarch 19, 2019

Last NPPES UpdateDecember 19, 2023

NPPES CertifiedDecember 19, 2023

✔ NPI 1104385947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in NY · 031134✔ Licensed in NJ · 25MP00516300

3333 HYLAN BLVD, Staten Island, NY 10306

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Secondary Practice Location 1

Location 12 Center PlzTinton Falls, NJ 07724-9744 · Phone (732) 673-5131

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jeffrey Paul Licata Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901148436

PECOS Enrollment IDI20240207000566

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

475 services90 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

121 services108 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

112 services26 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

78 services78 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

63 services59 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

45 services44 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

44 services38 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

28 services28 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

16 services16 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

14 services14 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

12 services12 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

12 services12 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.65/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

86.65

Improvement Activities

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Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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