Active NPI
Patty C Licata, PT
- Orthopedic Physical Therapist
- Deltona, FL
National Provider Identifier
1780624734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT13460
- Practice address
- 1565 Saxon Blvd
Suite 301
Deltona, FL 32725-5876 - Phone
- (386) 851-0901
- Fax
- (386) 851-2426
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT13460 | FL | Primary |
Addresses
Primary practice location
1565 Saxon Blvd
Suite 301
Deltona, FL 32725-5876
Mailing address
701 Platinum PT
FL 4
Lake Mary, FL 32746-4871
Phone (407) 206-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y094Q | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
701 Platinum PT
FL 4
Lake Mary, FL 32746-4871
Phone (407) 236-0404
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.91 of 100
- Quality
- 61.18
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007709 | NY | MD | Registered Dietitian |
| PT13460 | FL | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | Accepting new patients |
Locations
701 Platinum Pt
Fl 4
Lake Mary, FL 32746
Phone (407) 236-0404
32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1780624734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PLATINUM PT",
"address_2": "FL 4",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327464871",
"telephone_number": "407-206-4500",
"fax_number": "407-643-2802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 SAXON BLVD",
"address_2": "SUITE 301",
"city": "DELTONA",
"state": "FL",
"postal_code": "327255876",
"telephone_number": "386-851-0901",
"fax_number": "386-851-2426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICATA",
"first_name": "PATTY",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "PT13460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y094Q",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.