Peter D Licht, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

017612 Issued in CT

Practice address

172 Mount Pleasant Rd
Newtown, CT 06470-1443

Phone

(203) 426-8442

Fax

(203) 270-7464

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Specialty

Internal Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peter Licht M.D. and Jennifer Holloway M.D LLC.Group PAC ID 7517860802, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Western Connecticut Home Care Inc Home health agency, Danbury, CT, CCN 077088
• Danbury Hospital Hospital, Danbury, CT, CCN 070033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.licht.1@15290.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peter Licht M.D. & Jennifer Holloway M.D LLC.

  • Internal Medicine Physician
  • Newtown, CT
  • NPI 1528286895
  Medicare reassignment Care Compare group NPD Authorized official

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

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation
• Western Connecticut Home Care, Inc

  • Home Health Agency
  • Danbury, CT
  • NPI 1083677132
  Care Compare affiliation

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1841267457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 MOUNT PLEASANT RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701443",
            "telephone_number": "203-426-8442",
            "fax_number": "203-270-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 MOUNT PLEASANT RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701443",
            "telephone_number": "203-426-8442",
            "fax_number": "203-270-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHT",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "017612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001176122",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110227989",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Lucille Larosa, M.D.
• Maurice Park Lee, M.D., PH.D.
• Sean Lee, DDS
• David C Levi, MD
• Barbara Joan Levy, OTR/L
• Susan K Licht, P.A.C.
• Lincare Inc.
• Kristie Liotta, MA, LPC
• Live Well Chiropractic Care LLC
• Kathleen Lombardi

• Internal Medicine Physician in Newtown, CT
• Providers in Newtown, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.