Individual provider

Jeffrey Licata, PA-C

Medical Physician Assistant Medicare enrolled

Jeffrey Licata, PA-C is a Medical Physician Assistant in Staten Island, NY, registered under NPI 1104385947.

Getting there

The practice address on file is 3333 HYLAN BLVD, Staten Island, NY 10306. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

3333 HYLAN BLVD, Staten Island, NY 10306 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
031134 NY Medical Physician Assistant primary
25MP00516300 NJ Medical Physician Assistant

Licences are recorded in 2 states: NY, NJ. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physician Assistant
PAC ID
6901148436

Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: New Jersey and New York. The practice address on file is in Staten Island, NY, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

NJ New Jersey
Licence
25MP00516300
Specialty
Medical Physician Assistant
Verify with the NJ board →
NY New York practice address
Licence
031134
Specialty
Medical Physician Assistant
Verify with the NY board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Medical covers

Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
363AM0700X Medical Physician Assistant Medical 031134 NY primary
363AM0700X Medical Physician Assistant Medical 25MP00516300 NJ

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104385947 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateMar 19, 2019
Last updatedDec 19, 2023
StatusActive
Sole proprietorNo
CredentialPA-C
Practice address 3333 HYLAN BLVD
Staten Island, NY 10306
(718) 667-7500
This record was updated on Dec 19, 2023, which is recent enough that the contact details are likely still accurate.

Number check

1104385947 passes the NPI check digit test The final digit 7 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 3 8 5 9 4
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 6 8 1 9 8

Sum = 63 · next multiple of 10 = 70 · check digit = 7 · actual last digit = 7

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104385947?
NPI 1104385947 is the National Provider Identifier assigned to Jeffrey Licata, PA-C in Staten Island, NY. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Medical cover?
Definition to come...
How do I contact Jeffrey Licata, PA-C?
The phone number on file with NPPES is (718) 667-7500, last updated Dec 19, 2023. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Jeffrey Licata, PA-C accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104385947 a valid number?
Yes. 1104385947 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.