IVAN ALEXIS LICEA TAMAYO MD
NPI 1669895223
Family Medicine in Montgomery, AL
About Ivan Alexis Licea Tamayo Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IVAN ALEXIS LICEA TAMAYO MD (NPI 1669895223) is an individual family medicine provider in Montgomery, Alabama, licensed in Alabama (L3510R) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS and is a graduate of Other (1988).
NPPES Registry Identity
Specialties & Licenses
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
Ivan Alexis Licea Tamayo Md 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 36116 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ivan Licea Tamayo's NPI number?
The NPI number for Ivan Licea Tamayo is 1669895223. It was assigned to this individual provider in the NPPES registry on January 31, 2014.
Where is Ivan Licea Tamayo located?
Ivan Licea Tamayo practices at 4371 Narrow Lane Rd, Montgomery, AL 36116. The listed phone number is (334) 613-3680.
What is Ivan Licea Tamayo's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Ivan Licea Tamayo enrolled in Medicare?
Yes. Ivan Licea Tamayo 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 Ivan Licea Tamayo was last updated on January 31, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Ivan Alexis Licea Tamayo, MD · NPI 1669895223
Family Medicine physician in Montgomery, Alabama. Individual provider, active in the CMS NPPES registry since January 31, 2014.
## Identity
- **NPI:** 1669895223 (Entity type: Individual)
- **Enumerated:** January 31, 2014
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** L3510R (Alabama)
- **Sole proprietor:** No
## Practice location
- **Address:** 4371 NARROW LANE RD, Montgomery, AL 36116-2971
- **Phone:** (334) 613-3680
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1988
## Record status
- **NPPES last updated:** January 31, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1669895223) · Data from the CMS NPPES public registry.