Individual provider Active NPI

Sandra C. Landry, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1104925734
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01050 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-7585
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01050 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other practice location 1

2 Dudley St
Providence, RI 02905-3236
Phone (401) 444-5891

Other identifiers 2

IdentifierTypeStateIssuer
110107462AMedicaidMA
3139529MedicaidNH

Other names 1

  • Sandra Claire Huber Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slandry5976@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041203000048 MA Practitioner - Physician Assistant 6800852773 Reassigns benefits to 4 organizations
I20230216002471 RI Practitioner - Physician Assistant 6800852773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

2 Dudley St
Providence, RI 02905-3248
Phone (401) 272-1800

593 Eddy St
Providence, RI 02903-4923

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1865MAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group, Inc CurrentSince Jan 17, 2009 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Oct 3, 2022 Accepting new patients
Rhode Island Hospital CurrentSince Feb 27, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2022 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Jul 26, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 1, 2022 Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Jan 17, 2009 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 26, 2025 Accepting new patients
Milford Regional Physician Group, Inc. Past Accepting new patients
Milford Regional Physician Group, Inc. Past Accepting new patients

Locations

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

300 Hanover St
Ste 2A
Fall River, MA 02720
Phone (508) 973-7774

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

9 Galen St
Watertown, MA 02472
Phone (617) 562-5413

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

2 Dudley St
Providence, RI 02905
Phone (401) 444-2299

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Organizations & group practices 13

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.

View all 13

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1104925734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-7585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053236",
            "country_code": "US",
            "telephone_number": "401-444-5891",
            "fax_number": "401-444-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "SANDRA",
        "middle_name": "C.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110107462A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3139529",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slandry5976@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "HUBER",
            "middle_name": "CLAIRE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.