Dr Manuel Licitra Fajardo, MD - Medicare Internal Medicine in Garden City, NY

  1. Home
  2. Internal Medicine
  3. NY
  4. Garden City
Dr Manuel Licitra Fajardo, MD is a medicare enrolled "Internal Medicine" physician in Garden City, New York. His current practice location is 100 Somerset Ave, Garden City, Garden City, New York. You can reach out to his office (for appointments etc.) via phone at (516) 741-4898.

Dr Manuel Licitra Fajardo is licensed to practice in New York (license number 279410) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1831461417.

Contact Information

Dr Manuel Licitra Fajardo, MD
100 Somerset Ave, Garden City,
Garden City, NY 11530-1231
(516) 741-4898
Not Available

Map and Direction




Physician's Profile

Full NameDr Manuel Licitra Fajardo
GenderMale
SpecialityInternal Medicine
Location100 Somerset Ave, Garden City, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1831461417
  • Provider Enumeration Date: 01/30/2012
  • Last Update Date: 01/23/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 3375764210
  • Enrollment ID: I20160909000762

Medical Identifiers

Medical identifiers for Dr Manuel Licitra Fajardo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1831461417NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 53519 (Connecticut)Secondary
208M00000XHospitalist 53519 (Connecticut)Secondary
208M00000XHospitalist 279410 (New York)Secondary
207R00000XInternal Medicine 279410 (New York)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. Dr Manuel Licitra Fajardo allows following entities to bill medicare on his behalf.
Entity NameUnited Medical Associates Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013972801
PECOS PAC ID: 0345144978
Enrollment ID: O20031125000020
Entity NameWhite Plains Hospital Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003089491
PECOS PAC ID: 4981593092
Enrollment ID: O20040420001230
Entity Name24 On Physicians Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578781787
PECOS PAC ID: 5698688141
Enrollment ID: O20070815000031
Entity NameLawrence Medical Associates Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023257441
PECOS PAC ID: 1759439631
Enrollment ID: O20090504000017
Entity NameNorth Shore-lij Medical Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053688572
PECOS PAC ID: 3375701568
Enrollment ID: O20120220000262
Entity NameWhite Plains Hospital Medical Center
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1992255392
PECOS PAC ID: 4981593092
Enrollment ID: O20161219001743

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 Manuel Licitra Fajardo 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
Dr Manuel Licitra Fajardo, MD
100 Somerset Ave, Garden City,
Garden City, NY 11530-1231

Ph: (516) 741-4898		Dr Manuel Licitra Fajardo, MD
100 Somerset Ave, Garden City,
Garden City, NY 11530-1231

Ph: (516) 741-4898

Reviews and Comments


Internal Medicine Doctors in Garden City, NY

Dr. Daniel S Donohue, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 975 Stewart Ave, Garden City, NY 11530
Phone: 516-222-8650    Fax: 516-745-5476
Lotika Singh, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 901 Stewart Ave Ste 201, Garden City, NY 11530
Phone: 516-227-3377    Fax: 516-227-3378
Peter Malamas, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1111 Franklin Ave, Garden City, NY 11530
Phone: 516-222-8600    Fax: 516-222-8690
Jung H Youn, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1000 Franklin Ave, Suite 300, Garden City, NY 11530
Phone: 516-248-6868    Fax: 516-248-6841
Dr. Miguel Cima, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 877 Stewart Ave, Suite 28, Garden City, NY 11530
Phone: 516-222-1000    Fax: 516-222-1017
Dr. Philip Stein, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 975 Stewart Ave, Garden City, NY 11530
Phone: 516-222-8630    Fax: 516-745-5476
Adiba A Geeti, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1111 Franklin Ave, Garden City, NY 11530
Phone: 516-663-2834    Fax: 516-663-4696

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.