Kristen J Landt, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103778 Issued in FL

Practice address

1000 36TH St
Emergency Department
Vero Beach, FL 32960-4862

Phone

(772) 567-4311

Fax

(904) 346-0113

NPI assigned

Sep 20, 2006

Last updated

May 8, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kristen J Reale Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Associates Inc

  • Emergency Medicine Physician
  • Vero Beach, FL
  • NPI 1366437386
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1063519221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19726",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331019726",
            "telephone_number": "772-465-9770",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDT",
        "first_name": "KRISTEN",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "REALE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Celena Lamonda
• Deborah Sue Lampert, MA ED
• Michele Land, PT
• Matthew Landry, PHARMD
• Larry Landsman, MD
• Sarah Lang, PA-C
• Joanna Justine Langello, APRN FNP-C
• Amber Langlois
• Meagan Langmaid
• Ashley Lanier, APRN

• Physician Assistant in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.