Jim Licandro, DPM

InactiveIndividual ProviderPodiatry
NPI issued: July 7, 2005

Quick Facts

NPI Number
1609873538
TypeIndividual
StatusInactive
SpecialtyPodiatry
Taxonomy213E00000X — Podiatry
Phone
(832) 425-7457
StateIA

NPI Validation Status: Deactivated

✅Valid 10-digit NPI number (1609873538)
❌Active status: Deactivated / Inactive
✅Verified by CMS NPPES Registry
✅HIPAA compliant identifier
✅Enumeration date on file (July 7, 2005)
Data source: CMS NPPES

Provider Overview

JIM LICANDRO, DPM is a Podiatry provider based in Long Grove, IA who has been registered with CMS since 2005. This NPI is currently Deactivated under CMS NPPES registry.

Provider Details

NPI Number1609873538
Provider TypeIndividual Provider
GenderMale
CredentialDPM
StatusInactive
Enumeration DateJuly 7, 2005

Practice Location

CityLong Grove
StateIA
ZIP Code52756
Phone(832) 425-7457

Specialties & Licenses

★ Primary
SpecialtyPodiatry
Taxonomy Code213E00000X
License StateIA

Mailing Address

CityLong Grove
StateIA
ZIP Code52756
Phone(832) 425-7457
Same as practice location

How to Use This NPI

📋

For Insurance Billing

Use NPI 1609873538 in Box 33 of the CMS-1500 claim form. This number is required by all major insurance carriers to identify the billing provider and process electronic medical claims.

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For Credentialing

Reference NPI 1609873538for provider credential verification. Hospital systems, state licensing boards, and CAQH directories query this number to verify the provider's active clinical status.

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For Patients

Share NPI 1609873538 with your insurance company. If you need to verify out-of-network benefits or file a reimbursement claim, your insurance provider will require this number to process it.

About Podiatry

Specialists in Podiatry provide expert clinical care within their specific domain, focusing on the diagnosis, treatment, and management of conditions relevant to their field of practice.

Browse all Podiatryproviders →
📊
17,092
Podiatry Providers in the US

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People Also Ask

What is Jim Licandro's NPI number?
Jim Licandro's NPI number is 1609873538, a unique 10-digit identifier issued by the Centers for Medicare & Medicaid Services (CMS).
Is Jim Licandro's NPI currently active?
No, Jim Licandro's NPI status is Inactive as of the latest CMS NPPES database updates.
What does Jim Licandro specialize in?
Jim Licandro specializes in Podiatry. The healthcare taxonomy code associated with this specialty is 213E00000X.
Where does Jim Licandro practice?
Jim Licandro practices in Long Grove, IA 52756.
When was Jim Licandro's NPI issued?
Jim Licandro's NPI was issued on July 7, 2005.
What is Jim Licandro's provider type?
Jim Licandro is registered as an Individual Provider under CMS NPI Type 1.