Kathryn Deluise Liccardo, CPNP-PC - Medicare Nurse Practitioner in Buford, GA

  1. Home
  2. Nurse Practitioner
  3. GA
  4. Buford
Kathryn Deluise Liccardo, CPNP-PC is a medicare enrolled "Nurse Practitioner - Pediatrics" in Buford, Georgia. Her current practice location is 4095 S Lee St, Buford, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 932-8519.

Kathryn Deluise Liccardo is licensed to practice in Georgia (license number RN223459) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1497380497.

Contact Information

Kathryn Deluise Liccardo, CPNP-PC
4095 S Lee St,
Buford, GA 30518-3647
(770) 932-8519
(770) 533-4798

Map and Direction




Provider's Profile

Full NameKathryn Deluise Liccardo
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location4095 S Lee St, Buford, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1497380497
  • Provider Enumeration Date: 03/10/2020
  • Last Update Date: 08/17/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4880025816
  • Enrollment ID: I20200507001582

Medical Identifiers

Medical identifiers for Kathryn Deluise Liccardo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1497380497NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics RN223459 (Georgia)Primary

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. Kathryn Deluise Liccardo allows following entities to bill medicare on her behalf.
Entity NameThe Longstreet Clinic, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1326019977
PECOS PAC ID: 2668465733
Enrollment ID: O20040405001521

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. Kathryn Deluise Liccardo 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 AddressPractice Location Address
Kathryn Deluise Liccardo, CPNP-PC
Po Box 658,
Gainesville, GA 30503-0658

Ph: (770) 718-1122		Kathryn Deluise Liccardo, CPNP-PC
4095 S Lee St,
Buford, GA 30518-3647

Ph: (770) 932-8519

Reviews and Comments


Nurse Practitioner Nurses in Buford, GA

Anna A Alle, CNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 4349 Northmark Ln, Buford, GA 30518
Phone: 505-985-0948    
Andrea Yvette Mathador,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2805 Hamilton Mill Rd, Buford, GA 30519
Phone: 678-541-0588    Fax: 678-541-0610
Amy Willis Pitts, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4445 S Lee St Ste 105, Buford, GA 30518
Phone: 770-848-9240    
Mrs. Roghieh Beigom Kazeroonian, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2721 Buford Hwy, Buford, GA 30518
Phone: 770-945-4800    
Dr. Bunmi Yemisi Folarinde, PHD, APRN, FNP-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3616 S Bogan Rd Ste 202, Buford, GA 30519
Phone: 404-333-7652    
Mrs. Sophia Evette Jackson, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1950 Buford Hwy, Cvs Caremark Minute Clinic, Buford, GA 30518
Phone: 770-945-7286    
Coyette Annisee Telemaque, NP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 3331 Hamilton Mill Rd Ste 1102, Buford, GA 30519
Phone: 678-541-0588    Fax: 678-541-0610

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.