Individual provider Active NPI

Chad A Landwehr, P.A.

  • Medical Physician Assistant
  • Weston, WI
National Provider Identifier
1285893370
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2265-023 Issued in WI
Practice address
226070 Clearview Drive
Weston, WI 54476
Phone
(715) 574-5101
Fax
(715) 997-8663
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 2265-023 WI Primary

Addresses

Primary practice location

226070 Clearview Drive
Weston, WI 54476

Mailing address

226070 Clearview Drive
Weston, WI 54476
Phone (715) 301-5615

Other practice location 1

7402 Stone Ridge Drive
weston, WI 54476
Phone (715) 636-0590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160912001923 WI Order and Referring Only - Physician Assistant 7911078605

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2265-023WIMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: chad.landwehr@337248305217540.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1285893370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226070 CLEARVIEW DRIVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-301-5615",
            "fax_number": "715-997-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226070 CLEARVIEW DRIVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "54476",
            "telephone_number": "715-574-5101",
            "fax_number": "715-997-8663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7402 Stone Ridge Drive",
            "address_purpose": "LOCATION",
            "city": "weston",
            "state": "WI",
            "postal_code": "54476",
            "country_code": "US",
            "telephone_number": "715-636-0590",
            "fax_number": "715-240-5576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDWEHR",
        "first_name": "CHAD",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2265-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.