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DR. EDWIN ALPHONSE LICHWA II D.O.
NPI 1104856012
Family Medicine in West Sacramento, CA

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
500 JEFFERSON BLVD STE B180, WEST SACRAMENTO, CA 95605(916) 375-6400 Get Directions Write a Review

NPPES record last updated: December 16, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Edwin Alphonse Lichwa Ii D.o. NPPES

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

DR. EDWIN ALPHONSE LICHWA II D.O. (NPI 1104856012) is an individual family medicine provider in West Sacramento, California, licensed in California (A6985) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (1992).

NPPES Registry Identity

NPI1104856012
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. EDWIN ALPHONSE LICHWA IICredential: D.O.
Location Address500 JEFFERSON BLVD STE B180West Sacramento, CA 95605-2394
Mailing Address612 Snapdragon StWinters, CA 95694-1680 · (530) 795-0958
Phone(916) 375-6400
Sole ProprietorNo
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 1992
Enumeration DateJuly 4, 2006
Last NPPES UpdateDecember 16, 2021
✔ NPI 1104856012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A6985
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
500 JEFFERSON BLVD STE B180, West Sacramento, CA 95605
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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

Dr. Edwin Alphonse Lichwa Ii D.o. 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 ID9436102399
PECOS Enrollment IDI20050302001092
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95605 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
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 20

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

EVA AZUCENA BERNAL CAMPOS
Social Worker
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 370-3841
COMMUNICARE HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
IRINA BAILS P.A.
Physician Assistant
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 375-6400
COMMUNICARE HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
MRS. KATHERINE MARY SOLTERO LCSW
Social Worker (Clinical)
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
JASON ROSE PA
Physician Assistant
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
MS. HAEJIN REBECCA KIM PA
Physician Assistant
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900
KIMBERLY WARDEN NP
Nurse Practitioner (Family)
500 JEFFERSON BLVD STE B180
WEST SACRAMENTO, CA 95605
Yolo County (916) 403-2900

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 Edwin Lichwa's NPI number?

The NPI number for Edwin Lichwa is 1104856012. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Edwin Lichwa located?

Edwin Lichwa practices at 500 Jefferson Blvd Ste B180, West Sacramento, CA 95605. The listed phone number is (916) 375-6400.

What is Edwin Lichwa's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Edwin Lichwa enrolled in Medicare?

Yes. Edwin Lichwa 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.

When was this NPI record last updated?

The NPPES record for Edwin Lichwa was last updated on December 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.