Individual provider Active NPI

Stephen David Landaker, MD

  • Orthopaedic Surgery Physician
  • Chico, CA
National Provider Identifier
1720057557
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G41126 Issued in CA
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

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
ZZZ52846ZOtherBLUE SHIELD
00G411260MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000424 CA Practitioner - Orthopedic Surgery 8527966258 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41126CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Apr 15, 2016 Accepting new patients
Enloe Medical Center Orthopaedic Surgery CurrentSince Mar 1, 2015 Accepting new patients
Enloe Medical Center CurrentSince Mar 1, 2015 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.

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

Verify at the official NPI Registry.