Deborah Licata, PT in Morro Bay, CA - Medicare Physical Therapist Provider

Deborah Licata, PT is a medicare enrolled "Physical Therapist" provider in Morro Bay, California. Her current practice location is 890 Shasta Ave, Morro Bay, California. You can reach out to her office (for appointments etc.) via phone at (805) 772-4325.

Deborah Licata is licensed to practice in California (license number PT301323) 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 1578202123.

Contact Information

	Deborah Licata, PT
	890 Shasta Ave, Morro Bay, CA 93442-1933
	(805) 772-4325
	(805) 772-2886

Map and Direction

Healthcare Provider's Profile

Full Name	Deborah Licata
Gender	Female
Speciality	Physical Therapist
Location	890 Shasta Ave, Morro Bay, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578202123
Provider Enumeration Date: 06/01/2022
Last Update Date: 01/15/2024

Medicare PECOS Information:

PECOS PAC ID: 4981057684
Enrollment ID: I20240130000859

Medical Identifiers

Medical identifiers for Deborah Licata such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578202123	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT301323 (California)	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. Deborah Licata allows following entities to bill medicare on her behalf.

Provider Name	San Luis Physical Therapy & Orthopedic Rehabilitation Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1073552378 PECOS PAC ID: 7618872946 Enrollment ID: O20040117000206

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. Deborah 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
Deborah Licata, PT 408 Higuera St Ste 200, San Luis Obispo, CA 93401-6135 Ph: (805) 788-0805	Deborah Licata, PT 890 Shasta Ave, Morro Bay, CA 93442-1933 Ph: (805) 772-4325

Reviews and Comments

Physical Therapist in Morro Bay, CA

Marissa Marie Cotroneo, Physical Therapist Medicare: Medicare Enrolled Practice Location: 890 Shasta Ave, Morro Bay, CA 93442 Phone: 805-772-4325 Fax: 805-772-2886
Stephen Kerr, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Quintana Rd, Morro Bay, CA 93442 Phone: 805-772-7358
Lois Boulgarides, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Quintana Rd, Morro Bay, CA 93442 Phone: 805-772-7358
Michael James Williams, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 890 Shasta Ave, Morro Bay, CA 93442 Phone: 805-772-4325 Fax: 805-772-2886
Halie Gordon, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 500 Quintana Rd, Morro Bay, CA 93442 Phone: 805-772-7358
Eric Balash, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 890 Shasta Ave, Morro Bay, CA 93442 Phone: 805-772-4325 Fax: 805-772-2886
Dr. Alec Shahen Andoyan, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 Quintana Rd, Morro Bay, CA 93442 Phone: 805-772-7358

Deborah Licata, PT - Medicare Physical Therapist in Morro Bay, CA