Laura Lica

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3900 University Blvd S
Jacksonville, FL 32216-4331

Phone

(904) 222-6656

NPI assigned

Nov 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Davids Heart and Vascular PLLCGroup PAC ID 7012821879, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St David's Medical Center Hospital, Austin, TX, CCN 450431
• St David's South Austin Medical Center Hospital, Austin, TX, CCN 450713
• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• St Davids Heart & Vascular, PLLC

  • Cardiovascular Disease Physician
  • Austin, TX
  • NPI 1700887700
  Medicare reassignment Care Compare group

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

• St Davids Healthcare Partnership LP LLP

  dba Round Rock Medical Center

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. David'S Healthcare Partnership, L.P., LLP

  dba St. David's South Austin Medical Center

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1679528889
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  dba Heart Hospital of Austin

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1104692664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 BEACH BLVD APT 4212",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501837",
            "telephone_number": "734-649-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164331",
            "telephone_number": "904-222-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICA",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberator Health and Educational Services, Inc.
• Darlene Liberti
• Claudia Libertin, MD
• Liberty Ambulance Service Inc
• Amanda Liberty, LMT
• Dee Ray Lichty, CRNA
• Clare Liddon
• Anna Constance Lieber, MS
• Rachel Brenna Lieberman, AU.D.
• Shelley Ann Liebetrau, M.S., CF-SLP

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.