NPIMap

Individual provider Active NPI

Michael Edward Landis, M.D.

  • Vascular Surgery Physician
  • Williamsburg, VA
National Provider Identifier
1083709737
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101244851 Issued in VA
Practice address
400 Sentara Cir Ste 350
Williamsburg, VA 23188-5716
Phone
(757) 736-7250
Fax
(757) 510-9122
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01056946A IN
Vascular Surgery Physician 2086S0129X 0101244851 VA Primary

Addresses

Primary practice location

400 Sentara Cir Ste 350
Williamsburg, VA 23188-5716

Mailing address

400 Sentara Cir Ste 350
Williamsburg, VA 23188-5716
Phone (757) 736-7250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090126000721 VA Practitioner - Vascular Surgery 8224080320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Georgetown University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

400 Sentara Circle
350 Vascular and Transplant Specialists
Williamsburg, VA 23188-5716
Phone (757) 345-4460

Hospital & facility affiliations

  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal20
Leg revascularization (restoring blood flow)28
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01056946AINMDVascular Surgery Physician
0101244851VAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Vascular Surgery CurrentSince Feb 1, 2009 Accepting new patients
Jordan Physician Associates, Inc. Vascular Surgery Past Accepting new patients
St. Francis Hospital and Health Centers Vascular Surgery Past Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

397 Little Neck Rd
Ste 150
Virginia Beach, VA 23452
Phone (757) 333-3870

400 Sentara Cir
Ste 350
Williamsburg, VA 23188
Phone (757) 345-4460

Interoperability endpoints

  • Direct secure messaging: mlandis22178@direct.sentara.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1083709737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 350",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-736-7250",
            "fax_number": "757-510-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 350",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-736-7250",
            "fax_number": "757-510-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01056946A",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101244851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.