DAVID M LANDIS PA-C
NPI 1104044247
Physician Assistant - Medical in Boise, ID
About David M Landis Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID M LANDIS PA-C (NPI 1104044247) is an individual medical provider in Boise, Idaho, licensed in Idaho (PA165) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
David M Landis Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BOISE, ID 83702
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is David Landis's NPI number?
The NPI number for David Landis is 1104044247. It was assigned to this individual provider in the NPPES registry on April 23, 2007.
Where is David Landis located?
David Landis practices at 703 S Americana Blvd Ste 130, Boise, ID 83702. The listed phone number is (208) 706-7500.
What is David Landis's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is David Landis enrolled in Medicare?
Yes. David Landis is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for David Landis was last updated on January 15, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.
# David M Landis, PA-C · NPI 1104044247
Medical physician in Boise, Idaho. Individual provider, active in the CMS NPPES registry since April 23, 2007.
## Identity
- **NPI:** 1104044247 (Entity type: Individual)
- **Enumerated:** April 23, 2007
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA165 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 703 S AMERICANA BLVD, STE 130, Boise, ID 83702-5099
- **Phone:** (208) 706-7500
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** January 15, 2014
- **Other identifiers:** Medicare PIN 20002979 (ID); Other RPA-165 (ID)
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Source: [NPI Profile](https://npiprofile.com/npi/1104044247) · Data from the CMS NPPES public registry.