Individual provider Active NPI

Jeffrey H Landau, M.D.

  • Urology Physician
  • Allen, TX
National Provider Identifier
1891788022
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
K4934 Issued in TX
Practice address
1105 Central Expy N
Suite 350
Allen, TX 75013-6103
Phone
(972) 747-4200
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 77084 MN
Urology Physician 208800000X G50587 CA
Urology Physician 208800000X K4934 TX Primary

Addresses

Primary practice location

1105 Central Expy N
Suite 350
Allen, TX 75013-6103

Mailing address

5100 W Eldorado Pkwy
Suite 102 PMB 901
McKinney, TX 75070-6309
Phone (972) 747-4200

Other practice location 1

1650 4th St SE
Rochester, MN 55904-4717
Phone (507) 529-6600

Other identifiers 2

IdentifierTypeStateIssuer
029520602MedicaidTX
8AJ901OtherTXBLUECROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20120517000238 TX Practitioner - Urology 6204723810
I20240619001020 CA Practitioner - Urology 6204723810 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G50587CAMDUrology Physician
77084MNMDUrology Physician
K4934TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince May 28, 2024 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Physicians Surgery Center LLC Past Accepting new patients

Locations

1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533
Phone (707) 427-5211

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1891788022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W ELDORADO PKWY",
            "address_2": "SUITE 102 PMB 901",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750706309",
            "telephone_number": "972-747-4200",
            "fax_number": "972-747-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY N",
            "address_2": "SUITE 350",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750136103",
            "telephone_number": "972-747-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 4th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559044717",
            "country_code": "US",
            "telephone_number": "507-529-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDAU",
        "first_name": "JEFFREY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "77084",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G50587",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "K4934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029520602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "8AJ901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.