Ivan R Landan, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

048973 Issued in MI

Practice address

557 Seminole Rd
Norton Shores, MI 49444-3719

Phone

(231) 722-7510

Fax

(231) 722-7513

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northland Radiology Inc

  • Diagnostic Radiology Physician
  • Southfield, MI
  • NPI 1386804060

  Neurology

  Medicare reassignment NPD
• Northland Radiology Inc.

  • Physical Medicine & Rehabilitation Physician
  • Southfield, MI
  • NPI 1225652993
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1659341295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443719",
            "telephone_number": "231-722-7510",
            "fax_number": "231-722-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443719",
            "telephone_number": "231-722-7510",
            "fax_number": "231-722-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAN",
        "first_name": "IVAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "048973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2776688",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Concierge Medicine PLLC
• Lakeshore Derm & Laser Center PLC
• Lakeshore Integrative Mental Health Services, LLC
• Lakeshore Professional Eyecare PC
• Laketown Family Dental, PLLC
• Rachael Nicole Lane, DO
• Marissa F Lange
• Erlund John Larson, PHD.,MD
• Joseph Robert Larson, DMD, MD
• Carolyn Lawless, DPT

• Neurology Physician in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.

Verify at the official NPI Registry.