NPIMap

Individual provider Active NPI

Andrew James Landis, MD

  • Internal Medicine Physician
  • Fredonia, NY
National Provider Identifier
1467428425
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
191665-01 Issued in NY
Practice address
12 Center St
Ste #1
Fredonia, NY 14063-1769
Phone
(716) 679-2233
Fax
(716) 679-9698
NPI assigned
Feb 28, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191665-01 NY Primary

Addresses

Primary practice location

12 Center St
Ste #1
Fredonia, NY 14063-1769

Mailing address

12 Center St
Ste #1
Fredonia, NY 14063-1769
Phone (716) 679-2233

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrew.landis@upmcdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629000937 NY Practitioner - Internal Medicine 1052357027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

12 Ctr St
Fredonia, NY 14063-1769

207 Foote Ave
Jamestown, NY 14701-7077
Phone (716) 934-3641

31 Sherman St
Suite 2400
Jamestown, NY 14701-7082
Phone (814) 483-5306

33 N Main St
Cassadaga, NY 14718-9600
Phone (716) 595-3001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191665-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Area Medical Associates, L.L.P. Internal Medicine CurrentSince Jun 1, 1997 Accepting new patients
Great Lakes Physician Practice PC Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Durnc Operating LLC Past Accepting new patients

Locations

504 Central Ave
Dunkirk, NY 14048
Phone (716) 366-9008

529 Central Ave
Dunkirk, NY 14048
Phone (716) 338-9797

12 Center St
Fredonia, NY 14063
Phone (716) 664-8510

12 Center St
Ste 1
Fredonia, NY 14063
Phone (716) 672-5420

12 Center St
Ste 4
Fredonia, NY 14063
Phone (716) 672-8790

31 Sherman St
Ste 2400
Jamestown, NY 14701
Phone (814) 483-5306

Interoperability endpoints

  • Direct secure messaging: andrew.landis@upmcdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1467428425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CENTER ST",
            "address_2": "STE #1",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631769",
            "telephone_number": "716-679-2233",
            "fax_number": "716-679-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CENTER ST",
            "address_2": "STE #1",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631769",
            "telephone_number": "716-679-2233",
            "fax_number": "716-679-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-01-25",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "191665-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.landis@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fredonia, NY

Sources for this page

Verify at the official NPI Registry.