Dr Robert M Licata, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Shallotte, North Carolina. He went to Georgetown University School Of Medicine and graduated in 1971 and has 53 years of diverse experience with area of expertise as Psychiatry. He is a member of the group practice Coastal Horizons Center, Inc. and his current practice location is
120 Coastal Horizons Dr, Shallotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(910) 754-4515.
Dr Robert M Licata is licensed to practice in North Carolina (license number 2014-01510) 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 1669522769.
Physician's Profile
| Full Name | Dr Robert M Licata |
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| Gender | Male |
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| Speciality | Psychiatry |
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| Experience | 53 Years |
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| Location | 120 Coastal Horizons Dr, Shallotte, North Carolina |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Robert M Licata attended and graduated from Georgetown University School Of Medicine in 1971
NPI Data:
- NPI Number: 1669522769
- Provider Enumeration Date: 01/11/2007
- Last Update Date: 08/12/2015
Medicare PECOS Information:
- PECOS PAC ID: 2567611494
- Enrollment ID: I20151110000931
Medical Identifiers
Medical identifiers for Dr Robert M Licata such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669522769 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101027066 (Virginia) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2014-01510 (North Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Coastal Horizons Center, Inc. | 9739267964 | 32 |
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 Robert M Licata allows following entities to bill medicare on his behalf.
| Entity Name | Coastal Horizons Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922022607
PECOS PAC ID: 9739267964
Enrollment ID: O20080429000046 |
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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 Robert M 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 |
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Dr Robert M Licata, MD
6200 Cottage Creek Rd,
Southport, NC 28461-2983
Ph: (571) 216-1272 | Dr Robert M Licata, MD
120 Coastal Horizons Dr,
Shallotte, NC 28470-6094
Ph: (910) 754-4515 |
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