IndividualActive
Jim Licandro, DPM
NPI 1609873538 · Podiatrist · Long Grove, IA
Jim Licandro, DPM is a Podiatrist provider in Long Grove, IA (NPI 1609873538).
Provider details
- NPI number
- 1609873538
- Entity type
- Individual
- Primary specialty
- PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- License
- 00705 (IA)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
405 Woodlawn Rd
Long Grove, IA 52756
Phone: (832) 425-7457
Fax: (563) 285-5446
Street-level locationGet directions
Mailing address
5261 Boulder Dr Apt D
West Des Moines, IA 50265-7823
Registry dates
- Enumerated
- 2005-07-07
- Last updated
- 2018-07-22
Frequently asked questions
- What is Jim Licandro's NPI number?
- Jim Licandro's National Provider Identifier (NPI) is 1609873538, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jim Licandro's specialty?
- Jim Licandro is listed in the NPPES registry with a primary specialty of Podiatrist (Podiatric Medicine & Surgery Service Providers).
- Where is Jim Licandro located?
- Jim Licandro's practice location on file with NPPES is 405 Woodlawn Rd, Long Grove, IA 52756.
- What is Jim Licandro's phone number?
- The practice phone number listed in the NPPES registry for Jim Licandro is (832) 425-7457.
- Is Jim Licandro's NPI active?
- Yes — Jim Licandro's NPI (1609873538) is active in the NPPES registry as of the last update on 2018-07-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.