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SAMUEL D. LICCIARDO M.D.
NPI 1992025894
Emergency Medicine in Worcester, MA

Active since June 03, 2010PECOS Enrolled
100/100
CMS Quality Rating
55 LAKE AVE N, DEPARTMENT OF EMERGENCY MEDICINE, WORCESTER, MA 01655(508) 421-1400(508) 421-1490 Get Directions Write a Review

NPPES record last updated: October 28, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samuel D. Licciardo M.d. NPPES

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

SAMUEL D. LICCIARDO M.D. (NPI 1992025894) is an individual emergency medicine provider in Worcester, Massachusetts, licensed in Massachusetts (253748) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992025894
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameSAMUEL D. LICCIARDOCredential: M.D.
Location Address55 LAKE AVE N, DEPARTMENT OF EMERGENCY MEDICINEWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Phone(508) 421-1400
Fax(508) 421-1490
Sole ProprietorNo
Enumeration DateJune 3, 2010
Last NPPES UpdateOctober 28, 2013
✔ NPI 1992025894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MA · 253748
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
55 LAKE AVE N, Worcester, MA 01655
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Other Identifiers 3

Medicaid110095480AMA
Medicare PIN003053601MA
Medicare PIN003053602MA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel D. Licciardo M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 6

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
399 services390 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
63 services62 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
44 services44 patients
Ultrasound scan of chest 76604
An ultrasound scan of the chest is a non-invasive imaging procedure that uses sound waves to create pictures of the structures within your chest, such as your heart and lungs. It's a safe, painless method that helps doctors diagnose and monitor various conditions.
25 services25 patients
Ultrasound of heart, follow-up 93308
A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
18 services18 patients
Limited ultrasound scan of abdomen 76705
A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Samuel Licciardo's NPI number?

The NPI number for Samuel Licciardo is 1992025894. It was assigned to this individual provider in the NPPES registry on June 3, 2010.

Where is Samuel Licciardo located?

Samuel Licciardo practices at 55 Lake Ave N Department Of Emergency Medicine, Worcester, MA 01655. The listed phone number is (508) 421-1400.

What is Samuel Licciardo's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Samuel Licciardo enrolled in Medicare?

Yes. Samuel Licciardo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Licciardo was last updated on October 28, 2013. 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.