Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeffrey Paul Licata, PA-C

Individual provider Medical Physician Assistant · NPI 1104385947

Jeffrey Paul Licata, PA-C is a Physician Assistant in Staten Island, New York. Qualified in 2018, 8 years ago. Practices with Barnabas Health Medical Group PC, a 1,025-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
8
Licensed in
NJ, NY
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3333 Hylan Blvd
Staten Island, NY 10306-3608
Phone: (718) 667-7500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2 Center Plz, Tinton Falls, NJ 07724-9744 — (732) 673-5131

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 031134 (NY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 25MP00516300 (NJ)

Record details

NPI number1104385947
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 19, 2019
Last updated in NPPESDecember 19, 2023
Certification dateDecember 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Barnabas Health Medical Group Pc — 1025 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Staten Island