Active NPI
Stephen David Landaker, MD
- Orthopaedic Surgery Physician
- Chico, CA
National Provider Identifier
1720057557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G41126
- Practice address
- 131 Raley Blvd
Chico, CA 95928-8347 - Phone
- (530) 897-4500
- Fax
- (530) 897-4544
- NPI assigned
- Mar 15, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G41126 | CA | Primary |
Addresses
Primary practice location
131 Raley Blvd
Chico, CA 95928-8347
Mailing address
131 Raley Blvd
Chico, CA 95928-8347
Phone (530) 897-4500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ52846Z | Other | BLUE SHIELD | |
| 00G411260 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G41126 | CA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enloe Medical Center | Current | Accepting new patients | |
| Enloe Medical Center | Orthopaedic Surgery | Current | Accepting new patients |
| Enloe Medical Center | Current | Accepting new patients |
Locations
1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470
1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6332
1026 Mangrove Ave
Ste 10
Chico, CA 95926
Phone (530) 332-7144
Organizations & group practices 3
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.
-
- Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
- Chico, CA
- NPI 1164885604
-
- Orthopaedic Surgery Physician
- Chico, CA
- NPI 1770905994
-
- Community/Retail Pharmacy
- Chico, CA
- NPI 1912949538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1720057557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 RALEY BLVD",
"city": "CHICO",
"state": "CA",
"postal_code": "959288347",
"telephone_number": "530-897-4500",
"fax_number": "530-897-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 RALEY BLVD",
"city": "CHICO",
"state": "CA",
"postal_code": "959288347",
"telephone_number": "530-897-4500",
"fax_number": "530-897-4544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDAKER",
"first_name": "STEPHEN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G41126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ52846Z",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G411260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.