DR. PAUL J LICATA D.O.
NPI 1225036981
Internal Medicine - Pulmonary Disease in New London, CT

Active since July 07, 2005PECOS EnrolledAccepts Medicare Assignment
492 MONTAUK AVE, NEW LONDON, CT 06320(860) 443-0305(860) 443-0823 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Paul J Licata D.o. NPPES

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

DR. PAUL J LICATA D.O. (NPI 1225036981) is an individual pulmonary disease provider in New London, Connecticut, licensed in Connecticut (000413) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Westerly Hospital, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (1992).

NPPES Registry Identity

NPI1225036981
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. PAUL J LICATACredential: D.O.
Location Address492 MONTAUK AVENew London, CT 06320-4615
Mailing Address492 Montauk AveNew London, CT 06320-4615 · (860) 443-0305 · Fax (860) 443-0823
Fax(860) 443-0823
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 1992
Enumeration DateJuly 7, 2005
Last NPPES UpdateJune 23, 2025
NPPES CertifiedJune 23, 2025
NPI 1225036981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses Licensed in CT · 000413 Licensed in RI · DO00565
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
492 MONTAUK AVE, New London, CT 06320

Other Identifiers 3

MedicaidPL52716RI
Medicaid004242707CT
Medicaid001004134CT

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. Paul J Licata 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 ID7810890886
PECOS Enrollment IDI20040414000721, I20100323000616
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 3

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
185 services87 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
126 services124 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
118 services55 patients

Hospital Affiliations CMS Care Compare

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

Westerly Hospital

Acute Care Hospitals · Westerly, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410013
Location25 Wells StreetWesterly, RI 02891 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06320 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%229 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers26 claims26 services$36.32 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers26 claims26 services$90.81 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers28 claims82 services$34.96 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers16 claims93 services$17.07 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
5 suppliers15 claims71 services$10.89 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers31 claims31 services$46.22 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Gerontology)
492 MONTAUK AVE
NEW LONDON, CT 06320
Internal Medicine (Pulmonary Disease)
492 MONTAUK AVE
NEW LONDON, CT 06320

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 Paul Licata's NPI number?

The NPI number for Paul Licata is 1225036981. It was assigned to this individual provider in the NPPES registry on July 7, 2005.

Where is Paul Licata located?

Paul Licata practices at 492 Montauk Ave, New London, CT 06320. The listed phone number is (860) 443-0305.

What is Paul Licata's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Paul Licata enrolled in Medicare?

Yes. Paul Licata 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 Paul Licata affiliated with any hospitals?

According to CMS data, Paul Licata is affiliated with Westerly Hospital.

When was this NPI record last updated?

The NPPES record for Paul Licata was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.