ANDREA LANDIS (PA-C) – Physician Assistant, NPI 1073714259

ANDREA LANDIS (PA-C) is a healthcare provider. based in Allegan, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for ANDREA LANDIS (PA-C) is 1073714259

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA LANDIS (PA-C)
NPI
1073714259
Phone
(269) 686-5800
Address
551 LINN ST
Enumeration Date
29 May 2007
Last Update Date
20 January 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696864926
Graduation Year
2006 (20 years ago)
PAC ID
2668533381
Group Practice PAC ID
5092750356
Professional Enrollment ID
I20081212000305
Address ID
MI490101595AL551XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:19State licenses:0Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

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Provider Addresses for ANDREA LANDIS (PA-C)

  • 551, Linn Street, Allegan, Allegan Township, Allegan County, Michigan, 49010, United States

    ALLEGAN, MI 490101595

    Phone: (269) 686-5800

    Fax: (269) 686-5899

    Mailing address matches the actual address.

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: 2008-12-12

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
I20081212000305IPhysician AssistantMITBD

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 49010)

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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: 5092750356View full group profile

Reviews

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Frequently asked questions

Is there an official ID for ANDREA LANDIS (PA-C) in U.S. healthcare records?
The official identifier for ANDREA LANDIS (PA-C) is NPI 1073714259.
Would ANDREA LANDIS (PA-C) appear as active to a payer?
You can treat ANDREA LANDIS (PA-C) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to ANDREA LANDIS (PA-C)?
ANDREA LANDIS (PA-C)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ANDREA LANDIS (PA-C)?
Travel planning: use Allegan, Michigan as the reference point for ANDREA LANDIS (PA-C), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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