JULIE K LANDECKER (DPT) – Physical Therapist, NPI 1780647693

JULIE K LANDECKER (DPT) is a healthcare provider. based in Santa rosa, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 41483 (CA). The NPI Number for JULIE K LANDECKER (DPT) is 1780647693

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
JULIE K LANDECKER (DPT)
NPI
1780647693
Phone
(844) 527-7369
Address
220 CONCOURSE BLVD
Enumeration Date
11 April 2006
Last Update Date
9 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8445277369
Graduation Year
2010 (16 years ago)
PAC ID
8325489164
Group Practice PAC ID
0840553715
Professional Enrollment ID
I20240510002975
Address ID
CA954766920SO181XXSTXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for JULIE K LANDECKER (DPT)

  • 220 CONCOURSE BLVD

    SANTA ROSA, CA 954038210

    Phone: (844) 527-7369

    Fax: (844) 847-4943

    Type: Mailing

  • 901, Spencer Avenue, Santa Rosa, Sonoma County, California, 95404, United States

    SANTA ROSA, CA 954043813

    Phone: (707) 339-3423

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240510002975IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95403)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840553715View full group profile
NameSpecialtyState
Pain Management, AnesthesiologyCA
Nurse PractitionerCA
Anesthesiology, Pain ManagementCA
Pain Management, AnesthesiologyCA
Physical Therapist In Private PracticeCA
Nurse PractitionerCA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Can I verify JULIE K LANDECKER (DPT) with an NPI only?
You can start verification with NPI 1780647693 for JULIE K LANDECKER (DPT), then check state licensing separately.
Is JULIE K LANDECKER (DPT) listed as active for patients and plans?
The listing shows JULIE K LANDECKER (DPT) as active in the NPI system.
What is JULIE K LANDECKER (DPT)'s primary classification?
Physical Therapist is the headline specialty for JULIE K LANDECKER (DPT) here. Clinical services aligned with this taxonomy classification.
Does JULIE K LANDECKER (DPT) list a practice location?
Patients near Santa Rosa, California may find JULIE K LANDECKER (DPT) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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