NPIMap

Individual provider Active NPI

David Landau

  • Vascular Surgery Physician
  • Chicago, IL
National Provider Identifier
1083626113
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036-091566 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036-091566 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1740 W Taylor St
2200 Uich, MC 958
Chicago, IL 60612-7232
Phone (312) 996-7595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000192 NY Practitioner - Vascular Surgery 8426102740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)12
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-091566ILMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Aug 17, 2009 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients
The Board of Trustees of the University of Illinois PastSince Apr 6, 2023 Accepting new patients

Locations

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: david.landau@direct.stonybrookmedicine.edu

Organizations & group practices 3

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

Hospital & facility affiliations 12

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1083626113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "2200 UICH, MC 958",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-7595",
            "fax_number": "312-996-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAU",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036-091566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.