NPIMap

Individual provider Active NPI

Derek Landan, MD

  • Gastroenterology Physician
  • Scottsdale, AZ
National Provider Identifier
1477626810
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
28634 Issued in AZ
Practice address
14301 N 87TH St
Ste308
Scottsdale, AZ 85260-3686
Phone
(602) 787-1231
Fax
(602) 787-0021
NPI assigned
Nov 15, 2006
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 129419 MT
Gastroenterology Physician 207RG0100X 28634 AZ Primary

Addresses

Primary practice location

14301 N 87TH St
Ste308
Scottsdale, AZ 85260-3686

Mailing address

15560 N Frank Lloyd Wright Blvd
Ste B4 Box 415
Scottsdale, AZ 85260-2091
Phone (602) 787-1231

Other practice location 1

320 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 752-7441

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Direct Kalispell Regional Medical Center, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20240909003057 MT Practitioner - Gastroenterology 1456257229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Northeastern Ohio University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

320 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 756-3526

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy118
Upper gastrointestinal (GI) endoscopy for acid reflux283

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129419MTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Sep 9, 2024 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Glacier Regional Pathology, LTD. Current Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Sep 9, 2024 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients
Digestive Health Center of Arizona PastSince Nov 9, 2001 Accepting new patients

Locations

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

320 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 752-7441

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 8

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 8

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1477626810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15560 N FRANK LLOYD WRIGHT BLVD",
            "address_2": "STE B4 BOX 415",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602091",
            "telephone_number": "602-787-1231",
            "fax_number": "602-787-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14301 N 87TH ST",
            "address_2": "STE308",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603686",
            "telephone_number": "602-787-1231",
            "fax_number": "602-787-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-752-7441",
            "fax_number": "406-257-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDAN",
        "first_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "129419",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "28634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "320 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.