Dr Charles J Licata, DO in Bristol, CT - Medicare Internal Medicine

Dr Charles J Licata, DO is a medicare enrolled "Internal Medicine" physician in Bristol, Connecticut. He went to New York College Of Osteo Medicine Of New York Institute Of Technology and graduated in 1989 and has 35 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Prohealth Physicians Pc and his current practice location is 625 Clark Ave, Bristol, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 583-7700.

Dr Charles J Licata is licensed to practice in Connecticut (license number 000359) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538172523.

Contact Information

	Dr Charles J Licata, DO
	625 Clark Ave, Bristol, CT 06010-4068
	(860) 583-7700
	(860) 589-7656

Map and Direction

Physician's Profile

Full Name	Dr Charles J Licata
Gender	Male
Speciality	Internal Medicine
Experience	35 Years
Location	625 Clark Ave, Bristol, Connecticut
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Charles J Licata attended and graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 1989

NPI Data:

NPI Number: 1538172523
Provider Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1052456365
Enrollment ID: I20100310000788

Medical Identifiers

Medical identifiers for Dr Charles J Licata such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538172523	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	000359 (Connecticut)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Bristol Hospital	Bristol, CT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Prohealth Physicians Pc	1355246950	217

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Charles J Licata allows following entities to bill medicare on his behalf.

Entity Name	Prohealth Physicians Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720194053 PECOS PAC ID: 1355246950 Enrollment ID: O20031205000602

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles J Licata is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Charles J Licata, DO 4 Farm Springs Rd, Prohealth Physicians, Farmington, CT 06032-2573 Ph: (860) 284-5200	Dr Charles J Licata, DO 625 Clark Ave, Bristol, CT 06010-4068 Ph: (860) 583-7700

Reviews and Comments

Internal Medicine Doctors in Bristol, CT

Ronald S Green, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 25 Newell Rd, Suite E-36, Bristol, CT 06010 Phone: 860-583-9252 Fax: 860-585-9848
Daniel Norman Smiley, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 25 Newell Rd, Suite E-36, Bristol, CT 06010 Phone: 860-583-9252 Fax: 860-585-9848
Dr. Michael Owen Richards, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 41 Brewster Rd, Bristol, CT 06010 Phone: 860-585-3000
Michael Stephen Ptaszynski, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 25 Newell Rd, #d-25, Bristol, CT 06010 Phone: 860-314-6020 Fax: 860-314-6024
Dr. Robert C Debiase, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 25 Newell Rd, Suite D24, Bristol, CT 06010 Phone: 860-582-3235 Fax: 860-582-0692
Dr. Nandini Ravindra Menon, M.D Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 123 Maple St, Bristol, CT 06010 Phone: 860-584-8021 Fax: 860-584-9021
Christopher Wakem, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 44 Brewster Road, Hem/oncology Dept., Level A, Bristol, CT 06010 Phone: 860-585-3000 Fax: 860-585-3907

Dr Charles J Licata, DO - Medicare Internal Medicine in Bristol, CT