Serrie C Lico, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

24505 Issued in NV

Practice address

8530 W Sunset Rd Ste 110
Las Vegas, NV 89113-2244

Phone

(702) 240-6482

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NJ, OH, NV4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Thoracic Surgery

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nevada Heart and Vascular Center Resh LLPGroup PAC ID 5395746283, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
• Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slico1279463@direct.bsmhealth.org
• Direct secure messaging: serrie.lico.1@29724.direct.athenahealth.com

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.

• Nevada Heart and Vascular Center Resh LLP

  • Cardiovascular Disease Physician
  • Las Vegas, NV
  • NPI 1659387934
  Medicare reassignment Care Compare group NPD
• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  Medicare reassignment NPD
• Einstein Practice Plan Inc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment NPD
• Mercy Health Physicians Lima Specialty Care LLC

  • Surgery Physician
  • Lima, OH
  • NPI 1518589803
  Medicare reassignment NPD
• Nevada Heart and Vascular Center Resh LLP

  • Cardiac Rehabilitation Registered Nurse
  • Las Vegas, NV
  • NPI 1891482113
  NPD
• Atlanticare Physician Group, PA

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Einstein Practice Plan Inc

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1457047433
  NPD
• Einstein Practice Plan, Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Philadelphia, PA
  • NPI 1831141415
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Sunrise Hospital and Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1861439952
  Care Compare affiliation
• Bullhead City Hospital Corporation

  • General Acute Care Hospital
  • Bullhead City, AZ
  • NPI 1255302766
  Care Compare affiliation
• Bullhead City Hospital Corporation

  • Urgent Care Clinic/Center
  • Bullhead City, AZ
  • NPI 1780996223

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1790746790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S RANCHO DR STE E6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063812",
            "telephone_number": "702-240-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 W SUNSET RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132244",
            "telephone_number": "702-240-6482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Mercy Dr NW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447082624",
            "country_code": "US",
            "telephone_number": "330-588-4676",
            "fax_number": "330-588-4677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Mercy Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447082614",
            "country_code": "US",
            "telephone_number": "330-489-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICO",
        "first_name": "SERRIE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA10202300",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD068831L",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35.122143",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NV",
            "license": "24505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03112934",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mci@967.direct.myezyaccess.com",
            "affiliation": "Y",
            "affiliationName": "Mercy Professional Care, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1330 Mercy Dr NW Ste 101",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447082624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia Louise Licciardello
• Ma Victoria Licea
• Alyssa J Lichtenberger, O.M.D., L.AC.
• Tina Licina, O.D.
• Denise Helen Licini, NP
• Yunisleidy Licor Valle
• Tarabel Shantel Alvarez Licudo
• Christopher Liddle
• Daniel Lide
• J'Ree J'Nel Lide

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.