Victoria Lynn Landolt, D.O.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

5101015289 Issued in MI

Practice address

4717 Saint Antoine St
Detroit, MI 48201-1423

Phone

(313) 577-8900

Fax

(313) 577-0700

NPI assigned

Aug 17, 2006

Last updated

Oct 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Ophthalmology

Education

Michigan State University College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harper University Hospital Hospital, Detroit, MI, CCN 230104

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: victoria.landolt.1@19711.direct.athenahealth.com
• Direct secure messaging: vlandolt@direct.dmc.org
• Direct secure messaging: vlandolt1135707@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• University Physician Group

  dba Wayne State University Physician Group

  • Speech-Language Pathologist
  • Detroit, MI
  • NPI 1336417146
  NPD
• Charles G.Colombo, M.D., P.C.

  dba Orion Troy Ophthalmology

  • Specialist
  • Rochester Hills, MI
  • NPI 1598761827
  NPD (past)
• Holicki Eye Centers, P.C.

  • Ophthalmology Physician
  • Coldwater, MI
  • NPI 1811980386
  NPD (past)
• Marla J Price DO PLLC

  dba Byrd and Wyandotte Eye Clinic'

  • Ophthalmology Physician
  • Wyandotte, MI
  • NPI 1083894349
  NPD (past)
• Michigan Eye Care Provider PLLC

  dba Fraser Eye Care Center

  • Ophthalmology Physician
  • Fraser, MI
  • NPI 1598151318
  NPD (past)
• Holicki Optical Inc

  • Optometrist
  • Angola, IN
  • NPI 1821382714
  NPD (past)

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

• VHS Harper-Hutzel Hospital Inc

  dba Harper University Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1942313499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-577-8900",
            "fax_number": "313-577-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011423",
            "telephone_number": "313-577-8900",
            "fax_number": "313-577-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDOLT",
        "first_name": "VICTORIA",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101015289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "5101015289",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Lakeisha Landers
• Kristopher Ernest Landers, LLMSW
• Zachary Landers
• Richard Landgraf Jr., MA. LMSW.
• Emmylou Landicho, CNP
• Jawuan C Landrum, CPSS
• Vanessa Teal Landrum, CNM
• Nicole I Landry, OD
• Brittany Nicole Lane, MD
• Erin Lane, BSW, LLMSW

• Ophthalmology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.