ANTHONY LICCINI
NPI 1225569551
Pediatrics in Boise, ID

Q: What is Anthony Liccini's NPI number?

The NPI number for Anthony Liccini is 1225569551. It was assigned to this individual provider in the NPPES registry on March 27, 2017.

Q: What is Anthony Liccini's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Liccini was last updated on August 19, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 27, 2017PECOS Enrolled

305 E JEFFERSON ST, BOISE, ID 83712(208) 345-0715 Get Directions Write a Review

NPPES record last updated: August 19, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 19, 2022, Mar 22, 2021, Aug 21, 2020 and 3 more (6 updates tracked since 2017).

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About Anthony Liccini NPPES

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

ANTHONY LICCINI (NPI 1225569551) is an individual pediatrics provider in Boise, Idaho, licensed in Idaho (M-16632) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Toppenish.

NPPES Registry Identity

NPI1225569551

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameANTHONY LICCINI

Location Address305 E JEFFERSON STBoise, ID 83712-6231

Mailing Address190 E Bannock StBoise, ID 83712-6241 · (208) 381-8752 · Fax (509) 865-5783

Phone(208) 345-0715

Sole ProprietorNo

Enumeration DateMarch 27, 2017

Last NPPES UpdateAugust 19, 20226 updates tracked since enumeration

NPPES CertifiedAugust 19, 2022

✔ NPI 1225569551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in ID · M-16632✔ Licensed in WA · MD61058990

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

305 E JEFFERSON ST, Boise, ID 83712

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Secondary Practice Location 1

Location 1510 W 1st AveToppenish, WA 98948-1564 · Phone (509) 865-5600 · Fax (509) 865-5783

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anthony Liccini is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 83712 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

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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.

HAILEY LIZABETH COLLETTE MS

Dietitian, Registered (Nutrition, Pediatric)