1. Home
  2. Directory
  3. Virginia
  4. Fredericksburg
  5. Physician Assistant
  6. NPI Profile

MR. MICAIAH LANDRUM
NPI 1336967736
Physician Assistant in Fredericksburg, VA

Active since October 03, 2024PECOS EnrolledAccepts Medicare Assignment
1101 SAM PERRY BLVD STE 400, FREDERICKSBURG, VA 22401(540) 741-2871 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 16, 2025, Feb 14, 2025, Oct 3, 2024 (3 updates tracked since 2024).

About Mr. Micaiah Landrum NPPES

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

MR. MICAIAH LANDRUM (NPI 1336967736) is an individual physician assistant in Fredericksburg, Virginia, licensed in Virginia (0110010722) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS, is affiliated with Mary Washington Hospital, and maintains a secondary practice location in Manquin.

NPPES Registry Identity

NPI1336967736
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. MICAIAH LANDRUM
Location Address1101 SAM PERRY BLVD STE 400Fredericksburg, VA 22401-4466
Mailing Address1101 Sam Perry Blvd Ste 400Fredericksburg, VA 22401-4466 · (540) 741-2871
Phone(540) 741-2871
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 3, 2024
Last NPPES UpdateMay 16, 20253 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1336967736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in VA · 0110010722
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1101 SAM PERRY BLVD STE 400, Fredericksburg, VA 22401
Open in Google Maps ↗

Secondary Practice Location 1

Location 181 Birmingham CirManquin, VA 23106-3415 · Phone (804) 572-1760

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Micaiah Landrum is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072037225
PECOS Enrollment IDI20250409000526
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mary Washington Hospital

Acute Care Hospitals · Fredericksburg, VA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490022
Location1001 Sam Perry BoulevardFredericksburg, VA 22401 · Fredericksburg City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

WALTER ALVARADO NUNEZ
Physician Assistant
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2871
RICKY ALEXANDER PEREZ-MACIA
Student in an Organized Health Care Education/Training Program
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2865
AMANDA NICOLE COON FNP
Surgery (Vascular Surgery)
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2865
MICHAEL CALLANDER M.D.
Surgery (Surgical Critical Care)
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2871
MELISSA MURPHY PA-C
Physician Assistant
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2871
KIMBERLY BETH GORDON PA-C
Physician Assistant
1101 SAM PERRY BLVD STE 400
FREDERICKSBURG, VA 22401
Fredericksburg City (540) 741-2871

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 Micaiah Landrum's NPI number?

The NPI number for Micaiah Landrum is 1336967736. It was assigned to this individual provider in the NPPES registry on October 3, 2024.

Where is Micaiah Landrum located?

Micaiah Landrum practices at 1101 Sam Perry Blvd Ste 400, Fredericksburg, VA 22401. The listed phone number is (540) 741-2871.

What is Micaiah Landrum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Micaiah Landrum enrolled in Medicare?

Yes. Micaiah Landrum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Micaiah Landrum affiliated with any hospitals?

According to CMS data, Micaiah Landrum is affiliated with Mary Washington Hospital.

When was this NPI record last updated?

The NPPES record for Micaiah Landrum was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.