Individual provider Active NPI

Thomas Harold Landon, MD

  • Urology Physician
  • Lake St Louis, MO
National Provider Identifier
1073568382
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2014012158 Issued in MO
Practice address
300 Medical PLZ Ste 310
Lake St Louis, MO 63367-1484
Phone
(636) 625-2662
NPI assigned
May 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2014012158 MO Primary
Urology Physician 208800000X 35561 TN

Addresses

Primary practice location

300 Medical PLZ Ste 310
Lake St Louis, MO 63367-1484

Mailing address

PO Box 955534
Saint Louis, MO 63195-5534

Other practice location 1

901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 239-5155

Other identifiers 4

IdentifierTypeStateIssuer
7845411OtherTNCIGNA
P00004666OtherRR MEDICARE
3759065OtherAETNA
4057350OtherBCBS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tlandon352376@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028001432 MO Practitioner - Urology 2365478211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
R Franklin University of Med & Sci/Chicago Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1475 Kisker Rd
Suite 200
Saint Charles, MO 63304-8788
Phone (636) 498-5850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35561TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Jan 10, 2020 Accepting new patients
SSM Medical Group, Inc. CurrentSince Jan 10, 2020 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

300 Medical Plz
Ste 310
Lake St Louis, MO 63367
Phone (314) 291-6556

1475 Kisker Rd
Ste 200
Saint Charles, MO 63304
Phone (636) 498-5800

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

Interoperability endpoints

  • Direct secure messaging: tlandon503506@directc.mercy.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1073568382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631955534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ STE 310",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671484",
            "telephone_number": "636-625-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Patients First Dr",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630904700",
            "country_code": "US",
            "telephone_number": "636-239-5155",
            "fax_number": "636-239-1478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDON",
        "first_name": "THOMAS",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2014012158",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "35561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7845411",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00004666",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3759065",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4057350",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlandon352376@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tlandon352376@direct-ehr-ssmhc.com",
            "address_1": "300 Medical Plz Ste 310",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "300 Medical Plz Ste 310",
            "city": "Lake St Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633671484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.