Amanda Isabel Licea, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA08169 Issued in TX

Practice address

608 Radam LN
Austin, TX 78745-1172

Phone

(512) 443-5988

Fax

(512) 443-5055

NPI assigned

Nov 15, 2012

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

Texas Tech University Health Science Center School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.2 of 100Reported as group

Promoting interoperability

92

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandalicea@uroaustin.medalliesdirect.net

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.

• Urology Austin PLLC

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1225920945
  NPD
• Urology Austin, PLLC

  • Urology Physician
  • Austin, TX
  • NPI 1093837312

  Physician Assistant

  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1609110683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 N MOPAC EXPY STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598869",
            "telephone_number": "512-687-1950",
            "fax_number": "512-407-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 RADAM LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451172",
            "telephone_number": "512-443-5988",
            "fax_number": "512-443-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICEA",
        "first_name": "AMANDA",
        "middle_name": "ISABEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA08169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Annette Libios, LPC
• Libra Healthcare, LLC
• Libre Rehab Staffing, LLC
• Kelsey Amber Liburd, DNP, CPNP-AC
• Visar Lica
• Rachael Lichtenberger, PA-C
• J. Brad Lichtenhan, M.D.
• Stacy L Liddle, PT
• Amanda Lieberg
• Allen Keith Lieberman, MD

• Medical Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.