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JOSEPH LICITRA DC LLC
NPI 1902520109
Chiropractor in Bloomfield, NJ

Active since September 30, 2022
300 BROADACRES DR STE 126A, BLOOMFIELD, NJ 07003(973) 470-0632(973) 893-8259 Get Directions Write a Review

NPPES record last updated: September 30, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Joseph Licitra Dc Llc NPPES

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

JOSEPH LICITRA DC LLC (NPI 1902520109) is a healthcare organization registered as a chiropractor in Bloomfield, New Jersey and active in the NPI registry since September 2022. The organization lists Joseph Licitra, Owner, as its authorized official.

NPPES Registry Identity

NPI1902520109
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameJOSEPH LICITRA DC LLC
Location Address300 BROADACRES DR STE 126ABloomfield, NJ 07003-3153
Mailing Address300 Broadacres Dr Ste 126aBloomfield, NJ 07003-3153 · (973) 470-0632 · Fax (973) 893-8259
Phone(973) 470-0632
Fax(973) 893-8259
Organization SubpartNo
Authorized OfficialJoseph LicitraOwner · (201) 247-5363
Enumeration DateSeptember 30, 2022
NPPES CertifiedSeptember 30, 2022
✔ NPI 1902520109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
300 BROADACRES DR STE 126A, Bloomfield, NJ 07003
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joseph Licitra Dc Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Joseph Licitra Dc LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Joseph Licitra, DC
Chiropractic
NPI 1891795514
300 BROADACRES DR STE 126
Bloomfield, NJ 07003
(973) 470-0632
✔ Accepts MedicareSame address
Neal Shah, DPT
Physical Therapist in Private Practice
NPI 1104248350
15 COOGAN CT
Morris Plains, NJ 07950
(973) 634-3966
✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Joseph Licitra Dc LLC's NPI number?

The NPI number for Joseph Licitra Dc LLC is 1902520109. It was assigned to this organization in the NPPES registry on September 30, 2022.

Where is Joseph Licitra Dc LLC located?

Joseph Licitra Dc LLC is located at 300 Broadacres Dr Ste 126A, Bloomfield, NJ 07003. The listed phone number is (973) 470-0632.

What is Joseph Licitra Dc LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Joseph Licitra Dc LLC enrolled in Medicare?

Yes. Joseph Licitra Dc LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Joseph Licitra Dc LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Joseph Licitra Dc LLC, in Chiropractic and Physical Therapist in Private Practice. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Joseph Licitra Dc LLC was last updated on September 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.