David a Lickstein MD LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME84765 Issued in FL

Legal business name

DAVID A LICKSTEIN MD LLC

Practice address

5540 Pga Blvd
Suite 200
Palm Beach Gardens, FL 33418-3987

Phone

(561) 847-0970

Fax

(561) 508-8890

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

David Alan LicksteinNPI 1275642183

Title

Owner

Phone

(561) 571-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Alan Lickstein, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Palm Beach Gardens, FL
  • NPI 1275642183

  Plastic Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Craig Michael Forleiter, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Palm Beach Gardens, FL
  • NPI 1700178936
  Medicare reassignment Care Compare group NPD
• Christina Hobgood Naugle, PA-C

  • Surgical Physician Assistant
  • Palm Beach Gardens, FL
  • NPI 1609029305
  Medicare reassignment
• Thais Polanco, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Palm Beach Gardens, FL
  • NPI 1538515481
  NPD (past)

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1740738632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 PGA BLVD",
            "address_2": "SUITE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183987",
            "telephone_number": "561-571-4000",
            "fax_number": "561-508-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 PGA BLVD",
            "address_2": "SUITE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183987",
            "telephone_number": "561-847-0970",
            "fax_number": "561-508-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A LICKSTEIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "LICKSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-571-4000"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME84765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Darville-Hendrix, PHARMACIST(PHARM.D)
• Lynn Darville
• Alan Darwish, PTA
• Daughtry Eastridge & Katona MD PA
• Daughtry Eastridge and Katone MD PA
• David a. Goldman MD, LLC
• David S McEwen Dcpa
• David S. Bush, PH.D., P.a.
• David W Yates DMD PC
• Luke Alexander Davies

• Plastic Surgery Physician in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.