RICHARD ALFONSO LICON (PA-C) – Physician Assistant, NPI 1740428101
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
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Provider Addresses for RICHARD ALFONSO LICON (PA-C)
11, Technology Drive, Irvine Spectrum, Irvine, Orange County, California, 92618, United States
IRVINE, CA 926182302
Phone: (949) 923-3250
Fax: (855) 812-5865
Type: Mailing
Santa Margarita Parkway, Rancho Santa Margarita, Orange County, California, 92688, United States
RANCHO SANTA MARGARITA, CA 926883626
Phone: (949) 709-0988
Fax: (949) 709-8377
Type: Location
1401 W 1ST ST STE 101
SANTA ANA, CA 927033757
Phone: (714) 542-9700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-06-28 • Largest payer in this snapshot: Organon LLC ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-06-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050630000289 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 17 | 17 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 16 | 15 | $0 |
Insurance plans in this area (ZIP 92618)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Family Practice | CA | |
| Physician Assistant | CA | |
| Physician Assistant | CA |
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