KENNETH LANDIS M D A MEDICAL CORPORATION
NPI 1184799520
Internal Medicine in Marina Del Rey, CA

Q: What is Kenneth Landis M D A Medical Corporation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since November 21, 2006

4644 LINCOLN BLVD, SUITE 500, MARINA DEL REY, CA 90292(310) 822-2255(310) 822-0044 Get Directions Write a Review

NPPES record last updated: April 20, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 20, 2017, Feb 8, 2016 (2 updates tracked since 2016).

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About Kenneth Landis M D A Medical Corporation NPPES

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

KENNETH LANDIS M D A MEDICAL CORPORATION (NPI 1184799520) is a healthcare organization registered as an internal medicine in Marina Del Rey, California and active in the NPI registry since November 2006. The organization lists Kenneth Wayne Landis, President, as its authorized official.

NPPES Registry Identity

NPI1184799520

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameKENNETH LANDIS M D A MEDICAL CORPORATION

Location Address4644 LINCOLN BLVD, SUITE 500Marina Del Rey, CA 90292-6313

Mailing Address4644 Lincoln Blvd, Suite 500Marina Del Rey, CA 90292-6313 · (310) 822-2255 · Fax (310) 822-0044

Phone(310) 822-2255

Fax(310) 822-0044

Organization SubpartNo

Authorized OfficialKenneth Wayne LandisPresident · (310) 822-2255

Enumeration DateNovember 21, 2006

Last NPPES UpdateApril 20, 20172 updates tracked since enumeration

✔ NPI 1184799520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · G29787

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License G29787 (CA)

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License G29787 (CA)

4644 LINCOLN BLVD, Marina Del Rey, CA 90292

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Other Identifiers 4

Other290003222CA · Railroad Medicare

Medicaid00G297871CA

Medicaid00G297870CA

OtherCP9010Medicare Rrr

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Landis M D A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kenneth Landis M D A Medical Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kenneth Landis, M.D.

Internal Medicine

NPI 1861463077

4477 W 118TH ST STE 401
Hawthorne, CA 90250

(310) 822-2255

✔ PECOS✔ Accepts Medicare6.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kenneth Landis M D A Medical Corporation's NPI number?

The NPI number for Kenneth Landis M D A Medical Corporation is 1184799520. It was assigned to this organization in the NPPES registry on November 21, 2006.

Where is Kenneth Landis M D A Medical Corporation located?

Kenneth Landis M D A Medical Corporation is located at 4644 Lincoln Blvd Suite 500, Marina Del Rey, CA 90292. The listed phone number is (310) 822-2255.

What is Kenneth Landis M D A Medical Corporation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Landis M D A Medical Corporation enrolled in Medicare?

Yes. Kenneth Landis M D A Medical Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kenneth Landis M D A Medical Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Kenneth Landis M D A Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth Landis M D A Medical Corporation was last updated on April 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.