Individual provider Active NPI

Benjamin John Landis, MD

  • Pediatric Cardiology Physician
  • New Haven, CT
National Provider Identifier
1699928739
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
82414 Issued in CT
Practice address
330 Cedar St Ste LMP 4085
New Haven, CT 06510-3218
Phone
(203) 785-2022
Fax
(203) 737-2786
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 82414 CT Primary

Addresses

Primary practice location

330 Cedar St Ste LMP 4085
New Haven, CT 06510-3218

Mailing address

PO Box 208064
New Haven, CT 06520-8064
Phone (203) 785-2022

Other identifiers 1

IdentifierTypeStateIssuer
201294740MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, CT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150624001489 IN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 1153632682 Reassigns benefits to 1 organization
I20251031002413 CT Practitioner - Other (Physician) 1153632682 Reassigns benefits to 1 organization
I20251218001220 CT Practitioner - Pediatric Medicine 1153632682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Vanderbilt University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82414CTMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Nov 20, 2025 Accepting new patients
University Pediatric Associates, Inc. CurrentSince Jul 15, 2015 Accepting new patients
Greenwich Hospital CurrentSince Oct 16, 2025 Accepting new patients
Yale University CurrentSince Nov 20, 2025 Accepting new patients
Greenwich Hospital CurrentSince Oct 16, 2025 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

705 Riley Hospital Dr
#127
Indianapolis, IN 46202
Phone (317) 274-8906

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

Interoperability endpoints

  • Direct secure messaging: blandis@direct.iuhealth.org

Organizations & group practices 6

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1699928739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208064",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208064",
            "telephone_number": "203-785-2022",
            "fax_number": "203-737-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 CEDAR ST STE LMP 4085",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103218",
            "telephone_number": "203-785-2022",
            "fax_number": "203-737-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "BENJAMIN",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CT",
            "license": "82414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201294740",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.