Active NPI
Lauren Audrey Licata, MD
- Surgery Physician
- Middletown, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 278537
- Practice address
- 707 E Main St
Middletown, NY 10940-2650 - Phone
- (845) 333-7575
- NPI assigned
- May 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 255MA08698600 | NJ | |
| Surgical Critical Care Physician | 2086S0102X | 35123573 | OH | |
| Surgery Physician | 208600000X | 278537 | NY | Primary |
Addresses
Primary practice location
707 E Main St
Middletown, NY 10940-2650
Mailing address
707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575
Other practice location 1
68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04182261 | Medicaid | NY | |
| 0105408 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | llicata74847@direct.garnethealth.org | Direct | Garnet Health Doctors PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- New York Medical College, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909
Hospital & facility affiliations
- Garnet Health Medical Center
- Garnet Health Medical Center Catskills
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.1 of 100
- Quality
- 61
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.76
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 92 |
| Removal of skin lesions | 27 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 255MA08698600 | NJ | MD | Surgery Physician |
| 35123573 | OH | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York Surgicalist Services, P.C. | Surgery | Current | Accepting new patients |
| Garnet Health Doctors PC | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Current | Accepting new patients | |
| Hudson Vista Medical,PC | Surgery | Current | Accepting new patients |
| Garnet Health Doctors PC | Current | Accepting new patients | |
| Acute Care Surgery Medical Group, Inc. | Surgery | Current | Accepting new patients |
| 5 Pillars Billing, LLC | Surgery | Past | Accepting new patients |
| Garnet Health Medical Center | Past | Accepting new patients |
Locations
301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977
19 Laurel Ave
Ste LL1
Cornwall, NY 12518
Phone (845) 534-7080
75 Crystal Run Rd
Ste 240
Middletown, NY 10941
Phone (845) 333-7700
707 E Main St
Middletown, NY 10940
Phone (845) 333-1000
460 Gidney Ave
Newburgh, NY 12550
Phone (845) 458-4700
70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673
407 Gidney Ave
Ste B
Newburgh, NY 12550
Phone (845) 458-4700
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- llicata74847@direct.garnethealth.org
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Middletown, NY
- NPI 1093138851
-
- Surgery Physician
- Newburgh, NY
- NPI 1720663768
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- General Practice Physician
- Harris, NY
- NPI 1164845699
-
- Surgery Physician
- Putnam Valley, NY
- NPI 1922534254
-
- General Acute Care Hospital
- Middletown, NY
- NPI 1609875772
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Middletown, NY
- NPI 1609875772
-
- Rural Acute Care Hospital
- Harris, NY
- NPI 1710977012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1023337763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 E MAIN ST",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109402650",
"telephone_number": "845-333-7575"
}
],
"practiceLocations": [
{
"address_1": "68 Harris Bushville Rd",
"address_purpose": "LOCATION",
"city": "Harris",
"state": "NY",
"postal_code": "12742",
"country_code": "US",
"telephone_number": "845-333-8909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LICATA",
"first_name": "LAUREN",
"middle_name": "AUDREY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-20",
"last_updated": "2024-11-12",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "255MA08698600",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "OH",
"license": "35123573",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "278537",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04182261",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0105408",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "llicata74847@direct.garnethealth.org",
"affiliation": "Y",
"affiliationName": "Garnet Health Doctors PC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "707 E Main St",
"city": "Middletown",
"state": "NY",
"country_code": "US",
"postal_code": "109402650",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.