NPIMap

Individual provider Active NPI

Andro Reginald Luy Licaros, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1932856218
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1022644 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 632-4891
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1022644 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

75 Francis St
Boston, MA 02115-6106
Phone (617) 632-4891

Other practice location 1

55 Fruit St
Boston, MA 02114-2621
Phone (617) 724-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250701002607 MA Practitioner - Diagnostic Radiology 2062925282 Reassigns benefits to 3 organizations
I20260205002312 NH Practitioner - Diagnostic Radiology 2062925282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-5252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1022644MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 23, 2025 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
The General Hospital Corporation CurrentSince Jan 1, 2026 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

75 Francis St
Boston, MA 02115

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

67 Corporate Dr
#300
Portsmouth, NH 03801
Phone (603) 516-0092

Interoperability endpoints

  • Direct secure messaging: licaros.androreginald.bwh@direct.partners.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1932856218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-632-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-632-4891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICAROS",
        "first_name": "ANDRO REGINALD",
        "middle_name": "LUY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1022644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.