Rodrigo Landeros, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA60655595 Issued in WA

Practice address

7315 212TH St SW
Suite 201
Edmonds, WA 98026-7610

Phone

(425) 778-8116

NPI assigned

May 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026
• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rlanderos1042237@wm.providencedirect.org
• Direct secure messaging: rlanderos3910106@ghc.direct-ci.net

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.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment
• Vantage Radiology & Diagnostic Services, a Professional Services Corp

  • Diagnostic Radiology Physician
  • Renton, WA
  • NPI 1245230598
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463

  Surgical

  NPD
• Proliance Surgeons Inc., P.S.

  • Surgery Physician
  • Edmonds, WA
  • NPI 1073540894

  Surgical

  NPD
• Providence Health & Services - Washington

  • Internal Medicine Physician
  • Monroe, WA
  • NPI 1770734881
  NPD
• Imaging Partners at Valley LLC

  • Diagnostic Radiology Physician
  • Renton, WA
  • NPI 1215918081
  NPD (past)

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

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation
• Swedish Edmonds

  • General Acute Care Hospital
  • Edmonds, WA
  • NPI 1033107214
  Care Compare affiliation
• Swedish Edmonds

  • Clinical Medical Laboratory
  • Edmonds, WA
  • NPI 1699894022

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1902253172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 OLD POST RD",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605382609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW",
            "address_2": "SUITE 201",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-778-8116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11511 NE 10th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980048578",
            "country_code": "US",
            "telephone_number": "425-502-3000",
            "fax_number": "425-502-3589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDEROS",
        "first_name": "RODRIGO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60655595",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60655595",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Neil Mohan Lall, HCAC
• Nhi Lam
• Rachel Wright Lam
• Christa Lamothe, N.D.
• Karen Lamphere, MS, CN
• Elizabeth E Landrum, PH.D.
• Sarah Landrum
• Cailee Landsbury
• Kristopher Martin Lane, DC
• Madeleine Hope Laney

• Surgical Physician Assistant in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.