Active NPI
Mark Falon Landau, OD
- Optometrist
- Wyomissing, PA
National Provider Identifier
1164413316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OE-005894-T
- Practice address
- 555 Van Reed Rd
Wyomissing, PA 19610-1769 - Phone
- (610) 378-5560
- Fax
- (610) 378-1400
- NPI assigned
- Nov 4, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OE-005894-T | PA | Primary |
Addresses
Primary practice location
555 Van Reed Rd
Wyomissing, PA 19610-1769
Mailing address
555 Van Reed Rd
Wyomissing, PA 19610-1769
Phone (610) 378-5560
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LA193982 | Other | PA | HIGHMARK BLUE SHIELD |
| 01712901 | Other | PA | CAP BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE-005894-T | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1164413316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 VAN REED RD",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101769",
"telephone_number": "610-378-5560",
"fax_number": "610-378-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 VAN REED RD",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196101769",
"telephone_number": "610-378-5560",
"fax_number": "610-378-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDAU",
"first_name": "MARK",
"middle_name": "FALON",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OE-005894-T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "LA193982",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAP BLUE CROSS",
"identifier": "01712901",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.