SOPHIA MARIA LICURSI MD
NPI 1255035085
Student in an Organized Health Care Education/Training Program in Providence, RI

Q: What is Sophia Licursi's NPI number?

The NPI number for Sophia Licursi is 1255035085. It was assigned to this individual provider in the NPPES registry on March 27, 2023. The provider is also known as Sophia Maria Pantano.

Q: What is Sophia Licursi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Sophia Licursi was last updated on May 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since March 27, 2023PECOS Enrolled

593 EDDY ST, PROVIDENCE, RI 02903(401) 793-2695(401) 444-4165 Get Directions Write a Review

NPPES record last updated: May 23, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 23, 2026, Mar 27, 2023 (2 updates tracked since 2023).

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About Sophia Maria Licursi Md NPPES

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

SOPHIA MARIA LICURSI MD (NPI 1255035085) is an individual student in an organized health care education/training program in Providence, Rhode Island, licensed in Rhode Island (LP06874) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255035085

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSOPHIA MARIA LICURSICredential: MD

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 793-2695 · Fax (401) 444-4165

Phone(401) 793-2695

Fax(401) 444-4165

Sole ProprietorNo

Enumeration DateMarch 27, 2023

Last NPPES UpdateMay 23, 20262 updates tracked since enumeration

NPPES CertifiedMay 23, 2026

✔ NPI 1255035085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in RI · LP06874

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

593 EDDY ST, Providence, RI 02903

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Other Names 1

Former Name (1)Sophia Maria Pantano

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sophia Maria Licursi Md 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.

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.

DR. KEITH-AUSTIN SCARFO D.O.

Anesthesiology

593 EDDY ST, APC 6
PROVIDENCE, RI 02903

Providence County (401) 444-3777

AILEEN HSUEH

Surgery

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-8450

RHODE ISLAND HOSPITAL

General Acute Care Hospital

593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903

Providence County (401) 444-7585

DR. GA HIE NAM M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-5057

EUGENIE ATALLAH

Psychiatry & Neurology (Neurology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-2645

BRIAN CAO MD

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-4286

BRET CAULFIELD

Physician Assistant

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4000

JUNG HO GONG

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 793-2695

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 Sophia Licursi's NPI number?

The NPI number for Sophia Licursi is 1255035085. It was assigned to this individual provider in the NPPES registry on March 27, 2023. The provider is also known as Sophia Maria Pantano.

Where is Sophia Licursi located?

Sophia Licursi practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 793-2695.

What is Sophia Licursi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sophia Licursi enrolled in Medicare?

Yes. Sophia Licursi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sophia Licursi was last updated on May 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.