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CASEY M GALLAGHER-LICITRA RN, PMHNP
NPI 1215439336
Nurse Practitioner - Psychiatric/Mental Health in Ithaca, NY

Active since March 05, 2018PECOS EnrolledAccepts Medicare Assignment
201 E GREEN ST, ITHACA, NY 14850(607) 274-6200 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 7, 2025, Mar 5, 2018 (2 updates tracked since 2018).

About Casey M Gallagher-licitra Rn, Pmhnp NPPES

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

CASEY M GALLAGHER-LICITRA RN, PMHNP (NPI 1215439336) is an individual psychiatric/mental health provider in Ithaca, New York, licensed in New York (F405994) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, is affiliated with Cayuga Medical Center At Ithaca, and maintains a secondary practice location in Ithaca.

NPPES Registry Identity

NPI1215439336
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameCASEY M GALLAGHER-LICITRACredential: RN, PMHNP
Location Address201 E GREEN STIthaca, NY 14850-5635
Mailing Address102 Armstrong RdLansing, NY 14882-8904 · (607) 427-9970
Phone(607) 274-6200
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 5, 2018
Last NPPES UpdateJanuary 7, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2025
✔ NPI 1215439336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · F405994
Also ListedRegistered NurseTaxonomy 163W00000X · License 736778 (NY)
201 E GREEN ST, Ithaca, NY 14850
Open in Google Maps ↗

Other Names 1

Former Name (1)Casey Gallagher

Secondary Practice Location 1

Location 1101 Dates DrIthaca, NY 14850-1342 · Phone (607) 274-4011

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

Casey M Gallagher-licitra Rn, Pmhnp 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 ID4789113598
PECOS Enrollment IDI20250130002602
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

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

Cayuga Medical Center At Ithaca

Acute Care Hospitals · Ithaca, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330307
Location101 Dates DriveIthaca, NY 14850 · Tompkins County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14850 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

ISADORA HEROLD
Social Worker
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6200
MARLEY BROOKS LMSW
Social Worker
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6200
MELISSA NAYLOR LMSW
Social Worker (Clinical)
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6200
ARIANA OLSEN
Social Worker (Clinical)
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 319-6927
KATIE PETERS
Social Worker (Clinical)
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6200
MR. COLIN ANDREW POLNITSKY MSW INTERN
Counselor (Addiction (Substance Use Disorder))
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6288
BRENDA LEIGH HILL LCSW
Social Worker (Clinical)
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6200
KERRIE-ANNE PURRIER RN
Registered Nurse (Psychiatric/Mental Health)
201 E GREEN ST
ITHACA, NY 14850
Tompkins County (607) 274-6230

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 Casey Gallagher-licitra's NPI number?

The NPI number for Casey Gallagher-licitra is 1215439336. It was assigned to this individual provider in the NPPES registry on March 5, 2018. The provider is also known as Casey Gallagher.

Where is Casey Gallagher-licitra located?

Casey Gallagher-licitra practices at 201 E Green St, Ithaca, NY 14850. The listed phone number is (607) 274-6200.

What is Casey Gallagher-licitra's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Casey Gallagher-licitra enrolled in Medicare?

Yes. Casey Gallagher-licitra 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.

Is Casey Gallagher-licitra affiliated with any hospitals?

According to CMS data, Casey Gallagher-licitra is affiliated with Cayuga Medical Center At Ithaca.

When was this NPI record last updated?

The NPPES record for Casey Gallagher-licitra was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.