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LAURA LICA
NPI 1104692664
Physician Assistant in Jacksonville, FL

Active since November 27, 2023PECOS EnrolledAccepts Medicare Assignment
3900 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216(904) 222-6656 Get Directions Write a Review

NPPES record last updated: July 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2024, Jul 8, 2024 (2 updates tracked since 2024).

About Laura Lica NPPES

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

LAURA LICA (NPI 1104692664) is an individual physician assistant in Jacksonville, Florida and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, is affiliated with St David's Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1104692664
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLAURA LICA
Location Address3900 UNIVERSITY BLVD SJacksonville, FL 32216-4331
Mailing Address14051 Beach Blvd Apt 4212Jacksonville, FL 32250-1837 · (734) 649-3280
Phone(904) 222-6656
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 27, 2023
Last NPPES UpdateJuly 27, 20242 updates tracked since enumeration
NPPES CertifiedJuly 27, 2024
✔ NPI 1104692664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3900 UNIVERSITY BLVD S, Jacksonville, FL 32216
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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

Laura Lica 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 ID5092216895
PECOS Enrollment IDI20250902004036
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St David's Medical Center

Acute Care Hospitals · Austin, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450431
Location919 E 32nd StAustin, TX 78705 · Travis County
Emergency services Birthing friendly

Round Rock Medical Center

Acute Care Hospitals · Round Rock, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450718
Location2400 Round Rock AveRound Rock, TX 78681 · Williamson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

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

DR. MINNSUN KOH PARK M.D.
Internal Medicine (Cardiovascular Disease)
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 222-6656
RACHEL GREEN NP
Nurse Practitioner
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 222-6656
MISS BRANDY SHEREE FULTON MSN, APRN, FNP-BC
Nurse Practitioner (Family)
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 222-6656
DR. MAJDI ASHCHI DO
Internal Medicine (Cardiovascular Disease)
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 493-3333
CHARLES FRANCIS BOELTER PA-C
Physician Assistant
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 493-3333
HYE YUN KWAG PA
Physician Assistant
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (813) 482-5486
ASHCHI HEART & VASCULAR CENTER PA
Internal Medicine (Interventional Cardiology)
3900 UNIVERSITY BLVD S, SUITE A
JACKSONVILLE, FL 32216
Duval County (904) 222-6656
RON RAYMOND CABASAL OSORIO
Physician Assistant
3900 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216
Duval County (904) 222-6656

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laura Lica's NPI number?

The NPI number for Laura Lica is 1104692664. It was assigned to this individual provider in the NPPES registry on November 27, 2023.

Where is Laura Lica located?

Laura Lica practices at 3900 University Blvd S, Jacksonville, FL 32216. The listed phone number is (904) 222-6656.

What is Laura Lica's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Laura Lica enrolled in Medicare?

Yes. Laura Lica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Laura Lica accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Laura Lica as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Laura Lica affiliated with any hospitals?

According to CMS data, Laura Lica is affiliated with St David's Medical Center and Round Rock Medical Center.

When was this NPI record last updated?

The NPPES record for Laura Lica was last updated on July 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.