Derek Landes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004164 Issued in OH

Practice address

750 Mount Carmel Mall
Suite 300
Columbus, OH 43222-1553

Phone

(614) 224-6420

NPI assigned

Aug 25, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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, 2014

Medicare assignment

May accept Medicare assignment

Group practices

P.R. Care, LTDGroup PAC ID 8224089586, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• P.R. Care, LTD

  • Urgent Care Clinic/Center
  • Columbus, OH
  • NPI 1518945948
  Medicare reassignment Care Compare group
• Adena Medical Group LLC

  • Family Medicine Physician
  • Chillicothe, OH
  • NPI 1235468083
  Medicare reassignment
• Emergency Services, Inc.

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1952413031
  Medicare reassignment
• Mid-Ohio Emergency Services, LLC

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1386691780
  Medicare reassignment
• Emergency Services, Inc.

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1316925092
  NPD (past)

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1154721447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 HANBY AVE",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430811210",
            "telephone_number": "614-296-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MOUNT CARMEL MALL",
            "address_2": "SUITE 300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221553",
            "telephone_number": "614-224-6420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 Columbus Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Washington Court House",
            "state": "OH",
            "postal_code": "431601987",
            "country_code": "US",
            "telephone_number": "740-333-3333",
            "fax_number": "740-333-5171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDES",
        "first_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dereklandes@fcmhms.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1510 Columbus Ave Ste 230",
            "city": "Washington Court House",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431601987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ethan Land
• Bradley Norman Lander, PH.D., LICDC
• Kenia Lander
• Summer Landers
• Timothy Francis Landers, CNP
• Robert Taylor Landgraf, DDS
• Courtney Landin
• Emily Kay Landin
• Karly Landis, MS, CCC-SLP
• Shelby Landoll

• Physician Assistant in Columbus, OH
• Providers in Columbus, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.