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MR. MICHAEL R. LICATA CRNA
NPI 1356884746
Nurse Anesthetist, Certified Registered in Royal Oak, MI

Active since December 02, 2016
86.01/100
CMS Quality Rating
3601 W 13 MILE RD, ROYAL OAK, MI 48073(248) 898-7784(248) 898-8181 Get Directions Write a Review

NPPES record last updated: December 2, 2016. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Mr. Michael R. Licata Crna NPPES

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

MR. MICHAEL R. LICATA CRNA (NPI 1356884746) is an individual nurse anesthetist, certified registered in Royal Oak, Michigan, licensed in Michigan (4704272498) and active in the NPI registry since December 2016. He is affiliated with Beaumont Hospital Royal Oak and is a graduate of Oakland College Of Medicine And Surgery (2016).

NPPES Registry Identity

NPI1356884746
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. MICHAEL R. LICATACredential: CRNA
Location Address3601 W 13 MILE RDRoyal Oak, MI 48073-6712
Mailing Address130 Town Center Dr, 203Troy, MI 48084-1744 · (248) 585-8250 · Fax (248) 585-8270
Phone(248) 898-7784
Fax(248) 898-8181
Sole ProprietorNo
Medical School CMSOakland College Of Medicine And SurgeryGraduated 2016
Enumeration DateDecember 2, 2016
✔ NPI 1356884746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MI · 4704272498
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
3601 W 13 MILE RD, Royal Oak, MI 48073
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Michael R. Licata Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476835497
PECOS Enrollment IDI20170126000747

Hospital Affiliations CMS Care Compare

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

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

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.

86.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.29
Improvement Activities40

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.

AMIT BAHL MD, MPH
Emergency Medicine
3601 W 13 MILE RD, WILLIAM BEAUMONT HOSPITAL
ROYAL OAK, MI 48073
Oakland County (248) 898-0575
CATHERINE LEE PA
Physician Assistant
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 423-2481
DR. APARNA HARIHARAN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 898-9060
TERRENCE METZ
Radiology (Diagnostic Radiology)
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 898-5000
NICOLE MARIJANOVICH MD
Internal Medicine
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 898-7999
VINAYATA MANUBALLA KARETI D.O.
Internal Medicine (Gastroenterology)
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (661) 948-0803
WESLEY RICHARD BARNES M.D.
Surgery
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 898-2800
MELISSA JOY DREWRY M.D.
Pediatrics
3601 W 13 MILE RD
ROYAL OAK, MI 48073
Oakland County (248) 898-5000

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 Michael Licata's NPI number?

The NPI number for Michael Licata is 1356884746. It was assigned to this individual provider in the NPPES registry on December 2, 2016.

Where is Michael Licata located?

Michael Licata practices at 3601 W 13 Mile Rd, Royal Oak, MI 48073. The listed phone number is (248) 898-7784.

What is Michael Licata's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Michael Licata enrolled in Medicare?

Yes. Michael Licata is registered in the Medicare PECOS enrollment system.

Is Michael Licata affiliated with any hospitals?

According to CMS data, Michael Licata is affiliated with Beaumont Hospital Royal Oak.

When was this NPI record last updated?

The NPPES record for Michael Licata was last updated on December 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.