IndividualActive
Damon Licari, PA
NPI 1962495069 · Physician Assistant · Fairfax, VA
Provider details
- NPI number
- 1962495069
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 0110001250 (VA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(100/100 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
3 documented practice locations
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
8081 Innovation Park Dr Ste 602
Fairfax, VA 22031-4867
Phone: (571) 472-3270
Fax: (571) 472-3271
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 37174
Baltimore, MD 21297-3174
Additional practice locations (2)
- 3020 Hamaker Ct Ste 101Fairfax, VA 22031-2233Phone: (703) 289-9400Fax: (703) 289-9404
- 3300 Gallows RdFalls Church, VA 22042-3307Phone: (703) 776-4001Fax: (703) 776-7113
Registry dates
- Enumerated
- 2005-08-24
- Last updated
- 2022-03-15
- Certified
- 2022-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.