NPIMap

Individual provider Active NPI

Travis Landis, PA-C

  • Physician Assistant
  • Ravenna, OH
National Provider Identifier
1861961716
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005819RX Issued in OH
Practice address
6847 N Chestnut St
Ravenna, OH 44266-3929
Phone
(330) 297-0811
NPI assigned
Nov 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005819RX OH Primary

Addresses

Primary practice location

6847 N Chestnut St
Ravenna, OH 44266-3929

Mailing address

6847 N Chestnut St
Ravenna, OH 44266-3929
Phone (330) 297-0811

Other practice location 1

146 Peace Ln
Wadsworth, OH 44281-7812
Phone (330) 727-7588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190115002972 OH Practitioner - Physician Assistant 4486990249 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

13207 Ravenna Rd
Chardon, OH 44024-7032
Phone (440) 285-6000

7629 Market St
Youngstown, OH 44512-6051

7630 Southern Blvd
Youngstown, OH 44512-5633
Phone (330) 729-8000

8401 Market St
Youngstown, OH 44512-6725
Phone (330) 729-2929

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
63.13
Promoting interoperability
100
Improvement activities
40
Cost
74.18

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
71.12
Promoting interoperability
100
Improvement activities
40
Cost
75.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50.005819RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

Interoperability endpoints

  • Direct secure messaging: tlandis39743@ehrdirect.uhhospitals.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1861961716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-0811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Peace Ln",
            "address_purpose": "LOCATION",
            "city": "Wadsworth",
            "state": "OH",
            "postal_code": "442817812",
            "country_code": "US",
            "telephone_number": "330-727-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "TRAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005819RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.