Individual provider Active NPI

Frederick J Landenwitsch, MD

  • Family Medicine Physician
  • Claysville, PA
National Provider Identifier
1427001783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD045124L Issued in PA
Practice address
1263 Route 40 W
Claysville, PA 15323-1277
Phone
(724) 663-9018
Fax
(724) 663-9022
NPI assigned
May 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD045124L PA Primary

Addresses

Primary practice location

1263 Route 40 W
Claysville, PA 15323-1277

Mailing address

1263 Route 40 W
PO Box N
Claysville, PA 15323-1277
Phone (724) 663-9018

Other identifiers 1

IdentifierTypeStateIssuer
0012980200004MedicaidPA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000406 PA Practitioner - Family Practice 3274439823

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045124LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Claysville Family Practice Inc Family Medicine CurrentSince Nov 1, 2003 Accepting new patients
Washington Physician Services Family Medicine Past Accepting new patients

Locations

1263 State Route 40 W
Claysville, PA 15323
Phone (724) 663-7731

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427001783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 ROUTE 40 W",
            "address_2": "PO BOX N",
            "city": "CLAYSVILLE",
            "state": "PA",
            "postal_code": "153231277",
            "telephone_number": "724-663-9018",
            "fax_number": "724-663-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 ROUTE 40 W",
            "city": "CLAYSVILLE",
            "state": "PA",
            "postal_code": "153231277",
            "telephone_number": "724-663-9018",
            "fax_number": "724-663-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDENWITSCH",
        "first_name": "FREDERICK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD045124L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012980200004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claysville, PA

Sources for this page

Verify at the official NPI Registry.