MR. PAUL ANTHONY LICATA (PA-C) – Surgical Physician Assistant, NPI 1336187996

MR. PAUL ANTHONY LICATA (PA-C) is a healthcare provider. based in Tamarac, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA9102128 (FL). The NPI Number for MR. PAUL ANTHONY LICATA (PA-C) is 1336187996

Main info

Male
24 Years Of Experience
Name
MR. PAUL ANTHONY LICATA (PA-C)
NPI
1336187996
Phone
(954) 724-0276
Address
8105 NW 94TH AVE
Enumeration Date
3 June 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
6901387372
Professional Enrollment ID
I20260224001914
Address ID
OR977610000WAPOXXXBOXX201
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for MR. PAUL ANTHONY LICATA (PA-C)

  • 8105, Northwest 94th Avenue, Tamarac, Broward County, Florida, 33321, United States

    TAMARAC, FL 333211441

    Phone: (954) 724-0276

    Type: Mailing

  • 601, North Flamingo Road, Pembroke Pines, Broward County, Florida, 33028, United States

    PEMBROKE PINES, FL 330281015

    Phone: (954) 724-0276

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2026-02-24

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260224001914IPhysician AssistantTXTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33321)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. PAUL ANTHONY LICATA (PA-C)?
MR. PAUL ANTHONY LICATA (PA-C) — NPI 1336187996 — is the standard way to identify this listing.
Does the file indicate MR. PAUL ANTHONY LICATA (PA-C) is practicing under active NPI?
Directory data currently reports MR. PAUL ANTHONY LICATA (PA-C) as active.
What healthcare role does MR. PAUL ANTHONY LICATA (PA-C) hold?
Scheduling teams often label MR. PAUL ANTHONY LICATA (PA-C) under Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MR. PAUL ANTHONY LICATA (PA-C) based?
MR. PAUL ANTHONY LICATA (PA-C) is tied to Tamarac, Florida in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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