Kyle Landis, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

MA058329 Issued in PA

Practice address

200 S River St
Plains, PA 18705-1143

Phone

(570) 821-1100

Fax

(570) 821-1108

NPI assigned

Jul 26, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Merit-based Incentive Payment System (MIPS)

Final score

89.17 of 100Reported as apm

Quality

78.34

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kyle.landis.1@21771.direct.athenahealth.com

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.

• Commonwealth Physician Network LLC

  • Internal Medicine Physician
  • Kingston, PA
  • NPI 1003238635
  Medicare reassignment Care Compare group
• Scranton Quincy Clinic Company LLC

  • Family Medicine Physician
  • Scranton, PA
  • NPI 1508143074
  Medicare reassignment NPD
• Scranton Quincy Clinic Company LLC

  • Podiatrist
  • Scranton, PA
  • NPI 1902183304
  NPD

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

• Wilkes Barre Hospital Company LLC

  • Clinic/Center
  • Wilkes Barre, PA
  • NPI 1053554378

  Hospital

  Care Compare affiliation
• Wilkes Barre Hospital Company LLC

  • General Acute Care Hospital
  • Wilkes Barre, PA
  • NPI 1255585303
  Care Compare affiliation

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1144773151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051143",
            "telephone_number": "570-821-1100",
            "fax_number": "570-821-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S RIVER ST",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "187051143",
            "telephone_number": "570-821-1100",
            "fax_number": "570-821-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA058329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.landis.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "200 S River St",
            "city": "Plains",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187051143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ralph Joseph Kovaleski Jr., OTRL
• Lisa Kozden, MOT, OTR/L, CHT
• Brenda Kyttle, MPT
• Elaine M Lacey, PA C
• Karisa Lam
• Richard Neal Langdon Sr., D.C.
• Jonathan Lastovica
• Kelsey Ann Leedock, PA-C
• Megan Lynn Leva, MS OTR/L
• Linden Medical Group

• Surgical Physician Assistant in Plains, PA
• Providers in Plains, PA by specialty
• Surgical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.