DR. LICIA LYNN RAYMOND (MD) – Obstetrics & Gynecology Physician, NPI 1295751170

DR. LICIA LYNN RAYMOND (MD) is a healthcare provider. based in Salt lake city, Utah. specializing in Obstetrics & Gynecology Physician. They hold the professional credentials MD. They hold a License No. MD60660120 (WA). The NPI Number for DR. LICIA LYNN RAYMOND (MD) is 1295751170

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. LICIA LYNN RAYMOND (MD)
NPI
1295751170
Phone
(206) 320-4476
Address
PO BOX 25608
Enumeration Date
14 July 2006
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2065984333
Graduation Year
1985 (41 years ago)
PAC ID
6305909300
Group Practice PAC ID
0446162697
Professional Enrollment ID
I20170601000580
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience75
Completeness75
Years active:19State licenses:3Digital endpointsOther names

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Provider Addresses for DR. LICIA LYNN RAYMOND (MD)

  • PO BOX 25608

    SALT LAKE CITY, UT 841250608

    Phone: (206) 320-4476

    Fax: (206) 568-7643

    Type: Mailing

  • Northeast Blakely Drive, Issaquah, King County, Washington, 98029, United States

    ISSAQUAH, WA 980296201

    Phone: (425) 313-7080

    Fax: (425) 313-7071

    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 $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-01-16 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-16

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2017-06-01

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
I20170601000580IObstetrics/GynecologyWATBD

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 84125)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446162697View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. LICIA LYNN RAYMOND (MD) using NPI 1295751170?
NPI 1295751170 belongs to DR. LICIA LYNN RAYMOND (MD); compare other details if you need extra assurance.
Would DR. LICIA LYNN RAYMOND (MD) appear as active to a payer?
You can treat DR. LICIA LYNN RAYMOND (MD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. LICIA LYNN RAYMOND (MD)?
DR. LICIA LYNN RAYMOND (MD)'s record emphasizes Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. LICIA LYNN RAYMOND (MD)?
Directory geography for DR. LICIA LYNN RAYMOND (MD) centers on Salt Lake City, Utah.
What does 2 location(s) imply?
2 practice locations appear in the available data.