Active NPI
Mark Evan Landau, MD
- Neurology Physician
- Kailua, HI
National Provider Identifier
1447366349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD-10542
- Practice address
- 1331 Auwaiku St
Kailua, HI 96734-4106 - Phone
- (800) 348-4565
- Fax
- (888) 203-4247
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | DR.0065895 | CO | |
| Neurology Physician | 2084N0400X | ME153565 | FL | |
| Neurology Physician | 2084N0400X | MD2021-0447 | NM | |
| Clinical Neurophysiology Physician | 2084N0600X | 48556 | VA | |
| Neurology Physician | 2084N0400X | MD-10542 | HI | Primary |
Addresses
Primary practice location
1331 Auwaiku St
Kailua, HI 96734-4106
Mailing address
3 Maryland Farms Ste 200
Brentwood, TN 37027-5780
Phone (800) 348-4565
Other practice location 1
777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME153565 | FL | MD | Neurology Physician |
| MD2021-0447 | NM | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Remote Neuromonitoring Physicians ,PC | Neurology | Current | Accepting new patients |
| Sentient Physicians, P.C. | Neurology | Current | Accepting new patients |
Locations
777 Bannock St
Denver, CO 80204
3 Maryland Farms
Ste 200
Brentwood, TN 37027
Phone (615) 346-8733
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- mlandau604884@hisp.ehr.sutterhealth.org
Organizations & group practices 4
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.
-
- General Practice Physician
- Denver, CO
- NPI 1477569838
-
- Psychiatric Hospital Unit
- Denver, CO
- NPI 1689624942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1447366349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MARYLAND FARMS STE 200",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275780",
"telephone_number": "800-348-4565",
"fax_number": "888-203-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 AUWAIKU ST",
"city": "KAILUA",
"state": "HI",
"postal_code": "967344106",
"telephone_number": "800-348-4565",
"fax_number": "888-203-4247"
}
],
"practiceLocations": [
{
"address_1": "777 Bannock St",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802044507",
"country_code": "US",
"telephone_number": "303-436-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LANDAU",
"first_name": "MARK",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CO",
"license": "DR.0065895",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME153565",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NM",
"license": "MD2021-0447",
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "VA",
"license": "48556",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "HI",
"license": "MD-10542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.