Joseph Isaac Licata, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-06709 Issued in NC

Practice address

2301 Erwin Rd
Durham, NC 27705-4699

Phone

(919) 684-8111

NPI assigned

Sep 27, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
• Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Winston Salem, NC
  • NPI 1114584166
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020
  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156
  Care Compare affiliation
• Novant Health Mint Hill Medical Center, LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1972001469
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1093264459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277019890",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "JOSEPH",
        "middle_name": "ISAAC",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "001006709",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlicata505149@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2301 Erwin Rd",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277054699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Liberty Home Care, LLC
• Liberty Medical Specialties, Inc
• Craig Daniel Libman, PHD
• Joseph Dominick Licari
• Michaela Catherine Licari
• Lee H Lichtenwalter
• Rodger A Liddle, M.D.
• Catherine Lidov, M.S.W., L.C.S.W.
• Michael Evan Lidsky, M.D.
• Ralph A Liebelt, M.D.

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.