DR. JOSHUA EBENEZER LANDAVASO I MD
NPI 1053014738
Student in an Organized Health Care Education/Training Program in Great Falls, MT

Q: What is Joshua Landavaso's NPI number?

The NPI number for Joshua Landavaso is 1053014738. It was assigned to this individual provider in the NPPES registry on March 23, 2023.

Q: What is Joshua Landavaso's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Joshua Landavaso was last updated on June 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 23, 2023PECOS Enrolled

2800 11TH AVE S STE 24, GREAT FALLS, MT 59405(406) 771-6300(406) 731-8318 Get Directions Write a Review

NPPES record last updated: June 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2026, May 27, 2026, Mar 26, 2023 (3 updates tracked since 2023).

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About Dr. Joshua Ebenezer Landavaso I Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOSHUA EBENEZER LANDAVASO I MD (NPI 1053014738) is an individual student in an organized health care education/training program in Great Falls, Montana, licensed in Montana (173499) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Great Falls.

NPPES Registry Identity

NPI1053014738

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. JOSHUA EBENEZER LANDAVASO ICredential: MD

Location Address2800 11TH AVE S STE 24Great Falls, MT 59405-5263

Mailing AddressPo Box 6010Great Falls, MT 59406-6010 · (406) 455-5000

Phone(406) 771-6300

Fax(406) 731-8318

Sole ProprietorNo

Enumeration DateMarch 23, 2023

Last NPPES UpdateJune 2, 20263 updates tracked since enumeration

NPPES CertifiedJune 2, 2026

✔ NPI 1053014738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in MT · 173499

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2800 11TH AVE S STE 24, Great Falls, MT 59405

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Secondary Practice Location 1

Location 11101 26th St SGreat Falls, MT 59405-5161 · Phone (580) 481-4130

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Joshua Ebenezer Landavaso I Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREA MICHELLE BENDER DO