NPIMap

Individual provider Active NPI

Brandi Renae Landis, M.D.

  • Emergency Medicine Physician
  • Farmington, CT
National Provider Identifier
1891132254
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
16483 Issued in NV
Practice address
263 Farmington Ave
MC-1930
Farmington, CT 06032-1956
Phone
(860) 679-4988
NPI assigned
May 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16483 NV Primary
Emergency Medicine Physician 207P00000X 55520 CT

Addresses

Primary practice location

263 Farmington Ave
MC-1930
Farmington, CT 06032-1956

Mailing address

263 Farmington Ave
MC-1930
Farmington, CT 06032-1956
Phone (860) 679-4988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20160822002166 NV Practitioner - Emergency Medicine 5890016737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shadow Emergency Physicians PLLCGroup PAC ID 2860667375, 105 clinicians

Practice addresses (Care Compare)

620 Shadow LN
Las Vegas, NV 89106-4119
Phone (954) 939-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55520CTMDEmergency Medicine Physician
16483NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine Current Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

4980 W Sahara Ave
Ste 100
Las Vegas, NV 89146
Phone (702) 216-7365

Organizations & group practices 5

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1891132254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "MC-1930",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956",
            "telephone_number": "860-679-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "MC-1930",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956",
            "telephone_number": "860-679-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "BRANDI",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "16483",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "55520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.