CARMEN MARIE LICATA CRNA
NPI 1427988765
Nurse Anesthetist, Certified Registered in Novi, MI
About Carmen Marie Licata Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARMEN MARIE LICATA CRNA (NPI 1427988765) is an individual nurse anesthetist, certified registered in Novi, Michigan, licensed in Michigan (4704362843) and active in the NPI registry since May 2026. She is a graduate of Michigan State University College Of Human Medicine (2026).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Carmen Marie Licata Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Carmen Licata reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Southfield, MI 48075
- Reassigned Medicare billing, Michigan enrollment
- 122 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
NOVI, MI 48374
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 Carmen Licata's NPI number?
The NPI number for Carmen Licata is 1427988765. It was assigned to this individual provider in the NPPES registry on May 20, 2026.
Where is Carmen Licata located?
Carmen Licata practices at 47601 Grand River Ave, Novi, MI 48374. The listed phone number is (248) 465-4210.
What is Carmen Licata's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Carmen Licata enrolled in Medicare?
Yes. Carmen Licata is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Carmen Licata's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carmen Licata reassigns Medicare benefits to Henry Ford Health Providence Hospital (Southfield, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carmen Licata's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Carmen Licata was last updated on June 29, 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.
# Carmen Marie Licata, CRNA · NPI 1427988765
Nurse Anesthetist, Certified Registered physician in Novi, Michigan. Individual provider, active in the CMS NPPES registry since May 20, 2026.
## Identity
- **NPI:** 1427988765 (Entity type: Individual)
- **Enumerated:** May 20, 2026
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 4704362843 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 47601 GRAND RIVER AVE, Novi, MI 48374-1233
- **Phone:** (248) 465-4210
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Henry Ford Health Providence Hospital (NPI 1851339196, Southfield, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Michigan State University College Of Human Medicine, class of 2026
## Record status
- **NPPES last updated:** June 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1427988765) · Data from the CMS NPPES public registry.