NPIMap

Individual provider Active NPI

Amy L Licata, CRNP

  • Adult Health Nurse Practitioner
  • West Reading, PA
National Provider Identifier
1255393054
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP-007431 Issued in PA
Practice address
301 S 7TH Ave
Suite 2020
West Reading, PA 19611-1410
Phone
(610) 375-6565
Fax
(610) 375-2065
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP-007431 PA Primary

Addresses

Primary practice location

301 S 7TH Ave
Suite 2020
West Reading, PA 19611-1410

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0796

Other identifiers 1

IdentifierTypeStateIssuer
103102437MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100410000005 PA Practitioner - Nurse Practitioner 4183750615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Hahnemann University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reading HospitalGroup PAC ID 7618886490, 179 clinicians

Practice addresses (Care Compare)

301 S 7TH Ave
Suite 2020
West Reading, PA 19611-1495
Phone (610) 375-6565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Quality
77.19
Promoting interoperability
98
Improvement activities
40
Cost
79.03

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP-007431PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital CurrentSince May 1, 2024 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Mar 31, 2016 Accepting new patients
Tower Health Medical Group CurrentSince Mar 31, 2016 Accepting new patients
Reading Hospital Current Accepting new patients
Reading Hospital CurrentSince May 1, 2024 Accepting new patients
Reading Professional Services Past Accepting new patients

Locations

31 Industrial Dr
Ste 150
Hamburg, PA 19526
Phone (610) 376-8671

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

301 S 7th Ave
Ste 2020
West Reading, PA 19611

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

1320 Broadcasting Rd
Ste 100
Wyomissing, PA 19610

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1255393054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0796",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 7TH AVE",
            "address_2": "SUITE 2020",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111410",
            "telephone_number": "610-375-6565",
            "fax_number": "610-375-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP-007431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103102437",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.