Individual provider Active NPI

Jarett S Landman, PA-C

  • Surgical Physician Assistant
  • Peabody, MA
National Provider Identifier
1104804673
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1544 Issued in MA
Practice address
1 Orthopedics Dr
Peabody, MA 01960-1668
Phone
(978) 818-6350
Fax
(978) 818-6355
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1544 MA Primary

Addresses

Primary practice location

1 Orthopedics Dr
Peabody, MA 01960-1668

Mailing address

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040511000157 MA Practitioner - Physician Assistant 1658360037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine North Orthopaedic Surgery, Inc.Group PAC ID 0547259095, 87 clinicians

Practice addresses (Care Compare)

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1544MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine North Orthopaedic Surgery, Inc CurrentSince Mar 29, 2004 Accepting new patients
Orthopedics Surgical Center of the North Shore LLC Current Accepting new patients

Locations

1 Orthopedics Dr
Ste 2
Peabody, MA 01960
Phone (978) 818-6493

1 Orthopedics Dr
Peabody, MA 01960
Phone (781) 595-4562

Interoperability endpoints

  • Direct secure messaging: jarett.landman.1@7605.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236643200000",
    "number": "1104804673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDMAN",
        "first_name": "JARETT",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2009-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.