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JESSE JOSEPH LICUANAN M.D.
NPI 1396795514
Internal Medicine in Lakewood, CA

Active since May 10, 2006PECOS EnrolledAccepts Medicare Assignment
3650 SOUTH ST STE 403, LAKEWOOD, CA 90712(562) 531-0377 Get Directions Write a Review

NPPES record last updated: January 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jesse Joseph Licuanan M.d. NPPES

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

JESSE JOSEPH LICUANAN M.D. (NPI 1396795514) is an individual internal medicine provider in Lakewood, California, licensed in California (A87633) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1396795514
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJESSE JOSEPH LICUANANCredential: M.D.
Location Address3650 SOUTH ST STE 403Lakewood, CA 90712-1504
Mailing Address3650 South St Ste 403Lakewood, CA 90712-1504 · (562) 531-0377
Phone(562) 531-0377
Sole ProprietorYes
Medical School CMSOtherGraduated 1999
Enumeration DateMay 10, 2006
Last NPPES UpdateJanuary 6, 2023
NPPES CertifiedJanuary 6, 2023
✔ NPI 1396795514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A87633
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedSpecialistTaxonomy 174400000X · License A-87633 (CA)
3650 SOUTH ST STE 403, Lakewood, CA 90712
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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

Jesse Joseph Licuanan M.d. 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 ID3678547601
PECOS Enrollment IDI20040824001319
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 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
472 services243 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
342 services20 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
140 services17 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
108 services13 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
108 services16 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
78 services78 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90712 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers48 claims138 services$5.75 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers24 claims36 services$1.06 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims330 services$4.46 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims6,336 services$0.29 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier13 claims13 services$45.57 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
1 supplier12 claims12 services$37.97 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 4

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

COMPREHENSIVE WOMEN'S ANESTHESIA AND PAIN MANAGEMENT GROUP, INC.
Anesthesiology
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 634-8812
PROHEALTH PARTNERS A MEDICAL GROUP
Internal Medicine
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 531-0377
MIRIAM MACKOVIC-BASIC
Obstetrics & Gynecology
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 634-8812
NEHA BHANSALI M.D
Internal Medicine
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 531-0377

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 Jesse Licuanan's NPI number?

The NPI number for Jesse Licuanan is 1396795514. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Where is Jesse Licuanan located?

Jesse Licuanan practices at 3650 South St Ste 403, Lakewood, CA 90712. The listed phone number is (562) 531-0377.

What is Jesse Licuanan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jesse Licuanan enrolled in Medicare?

Yes. Jesse Licuanan 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.

When was this NPI record last updated?

The NPPES record for Jesse Licuanan was last updated on January 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.