Timothy Donald Landis, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

210815-1 Issued in NY

Practice address

1A Pine West PLZ
Albany, NY 12205-5557

Phone

(518) 862-1665

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Psychiatry

Education

Perelman School of Med at the University of Pennsylvania, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rensselaer County Bureau of FinanceGroup PAC ID 0749176923, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rensselaer County Bureau of Finance

  • Mental Health Counselor
  • Troy, NY
  • NPI 1932130358
  Medicare reassignment Care Compare group NPD
• Pine Bush Mental Health, LLP

  • Clinical Psychologist
  • Albany, NY
  • NPI 1962572362
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1972601425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PINE WEST PLZ",
            "address_2": "SUITE 510",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055587",
            "telephone_number": "518-690-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1A PINE WEST PLZ",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055557",
            "telephone_number": "518-862-1665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 7th Ave",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121803410",
            "country_code": "US",
            "telephone_number": "518-270-2800",
            "fax_number": "518-270-2707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "TIMOTHY",
        "middle_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "210815-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "210815-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION LICENSE",
            "identifier": "210815-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Lampman, OT
• Nassef Lancen, D.D.S.
• Kristen Marie Lancto, LMSW
• Michael A Landau, DMD
• Rhonda K B Landis, PHD
• Ashley Taylor Landry
• Mark Edward Lane, LCSW-R
• Alyson Ann Lang, FNP-BC
• Christine M Lang, M.D.
• John K. Lang Jr., CRNA

• Psychiatry Physician in Albany, NY
• Providers in Albany, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.