DR. JIM PAUL LICANDRO (DPM) – Podiatrist, NPI 1609873538

DR. JIM PAUL LICANDRO (DPM) is a healthcare provider. based in West des moines, Iowa. specializing in Podiatrist. They hold the professional credentials DPM. They hold a License No. 00705 (IA). The NPI Number for DR. JIM PAUL LICANDRO (DPM) is 1609873538

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. JIM PAUL LICANDRO (DPM)
NPI
1609873538
Phone
(563) 340-4387
Address
5261 BOULDER DR APT D
Enumeration Date
7 July 2005
Deactivation Date
21 March 2006
Reactivation Date
29 March 2006
Last Update Date
22 July 2018

Doctor Profile

Medical School Name
WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
-
Graduation Year
1997 (29 years ago)
PAC ID
6901860196
Professional Enrollment ID
I20041117000550
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

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Provider Addresses for DR. JIM PAUL LICANDRO (DPM)

  • 5261 BOULDER DR APT D

    WEST DES MOINES, IA 502657823

    Phone: (563) 340-4387

    Fax: (563) 424-7234

    Type: Mailing

  • 405, Woodlawn Road, Laglin, Long Grove, Scott County, Iowa, 52756, United States

    LONG GROVE, IA 52756

    Phone: (832) 425-7457

    Fax: (563) 285-5446

    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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 50265)

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Provider's Procedures

DR. JIM PAUL LICANDRO (DPM) performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYIA11056Removal of 2 to 4 thickened skin growths11879
PODIATRYIA11720Removal of tissue from 1 to 5 finger or toe nails57901994

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Frequently asked questions

Where can patients find DR. JIM PAUL LICANDRO (DPM)'s NPI?
You can confirm DR. JIM PAUL LICANDRO (DPM) with NPI 1609873538; it appears in the national provider directory.
Is DR. JIM PAUL LICANDRO (DPM) currently active in the NPI registry?
CMS-published data lists DR. JIM PAUL LICANDRO (DPM) as an active registrant.
Can you summarize DR. JIM PAUL LICANDRO (DPM)'s specialty in plain language?
Clinically, the directory lists DR. JIM PAUL LICANDRO (DPM) with Podiatrist. Clinical services aligned with this taxonomy classification.
Where does public data place DR. JIM PAUL LICANDRO (DPM)?
The snapshot lists West Des Moines, Iowa for DR. JIM PAUL LICANDRO (DPM); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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