Individual provider Active NPI

James Landero, D.O.

  • Dermatology Physician
  • Abilene, TX
National Provider Identifier
1396975850
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
N8206 Issued in TX
Practice address
1525 Hickory St
Abilene, TX 79601-2906
Phone
(325) 677-7546
Fax
(325) 676-7546
NPI assigned
Jul 19, 2009
Last updated
Feb 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X N8206 TX Primary
MOHS-Micrographic Surgery Physician 207ND0101X N8206 TX
Internal Medicine Physician 207R00000X OS10591 FL
Internal Medicine Physician 207R00000X N8206 TX

Addresses

Primary practice location

1525 Hickory St
Abilene, TX 79601-2906

Mailing address

1525 Hickory St
Abilene, TX 79601-2906
Phone (325) 677-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140103001165 TX Practitioner - DermatologyPractitioner - Internal Medicine 6800071945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Internal Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1525 Hickory St
Abilene, TX 79601-2906
Phone (325) 677-7546

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision55
Removal of skin lesions623
Removal of skin cancer49
Skin biopsy111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
N8206TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm-Blackhart, PLLC Dermatology CurrentSince Jun 15, 2024 Accepting new patients
Mountain West Derm - Blackhart PLLC Dermatology CurrentSince Jun 15, 2024 Accepting new patients
Premier Dermatology, PLLC Dermatology CurrentSince Apr 30, 2003 Accepting new patients

Locations

1525 Hickory St
Abilene, TX 79601
Phone (325) 677-7546

5625 Eiger Rd
Ste 105
Austin, TX 78735
Phone (512) 763-3760

7801 N Lamar Blvd
Ste D81
Austin, TX 78752
Phone (512) 868-3376

4513 Williams Dr
Georgetown, TX 78633

1320 Wonder World Dr
Ste 108
San Marcos, TX 78666
Phone (512) 392-1411

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1396975850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 HICKORY ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012906",
            "telephone_number": "325-677-7546",
            "fax_number": "325-676-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 HICKORY ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012906",
            "telephone_number": "325-677-7546",
            "fax_number": "325-676-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERO",
        "first_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-19",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "N8206",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "N8206",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10591",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N8206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.