Antonio M Licata, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

34.00512 Issued in OH

Practice address

1 Wyoming St
3 FL / Anes. Dept
Dayton, OH 45409

Phone

(937) 208-4380

Fax

(937) 208-3843

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

West Virginia School of Osteopathic Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• PHS Anesthesia Billing, LLC

  • Anesthesiology Physician
  • Middletown, OH
  • NPI 1578361044
  Medicare reassignment Care Compare group NPD
• Anesthesiology Services Network LTD

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1821076779
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1033197694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 632317",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632317",
            "telephone_number": "937-208-4380",
            "fax_number": "937-208-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "address_2": "3 FL / ANES. DEPT",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45409",
            "telephone_number": "937-208-4380",
            "fax_number": "937-208-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "ANTONIO",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34005132",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.00512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0932138",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Counseling and Consulting LLC
• Liberty Nursing Center of Bellbrook Inc
• Liberty Retirement Community of Washington Township, Inc.
• Liberty/Matrix of Oxford LLC
• Liberty/Matrix of Westwood LLC
• Grant Liebe, MD
• Janel Erin Lieber
• Margaret Liederbach, DO
• Brian Liepold
• Paige Elizabeth Liette, MSW, LIW-S

• Anesthesiology Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Anesthesiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.

Verify at the official NPI Registry.