KELLY LANDEEN (MD) – Otolaryngology Physician, NPI 1902394406
Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
273 OTOLARYNGOLOGY in MN
Provider Addresses for KELLY LANDEEN (MD)
11020 161st St W
Lakeville, MN 550446507
Phone: (651) 702-0750
Fax: (651) 645-6166
Type: Location
3460 Promenade Ave
Eagan, MN 551234404
Phone: (651) 702-0750
Fax: (651) 645-6166
Type: Location
3590 Arcade St
Vadnais Heights, MN 551277135
Phone: (651) 702-0750
Fax: (651) 645-6166
Type: Location
2651 Hillcrest Dr Ste 302
Hudson, WI 540169919
Phone: (651) 702-0750
Fax: (651) 645-6166
Type: Location
215 RADIO DR STE 202
WOODBURY, MN 551255822
Phone: (651) 705-0750
Fax: (651) 645-6166
Type: Mailing
217 RADIO DR
WOODBURY, MN 551255805
Phone: (651) 702-0750
Fax: (651) 645-6166
Type: Location
308, West LaQuinta Circle, Sioux Falls, Lincoln County, South Dakota, 57108, United States
SIOUX FALLS, SD 571082409
Phone: (605) 261-8029
Type: Mailing
Vanderbilt University Medical Center, 1211, Medical Center Drive, Nashville, Davidson County, Tennessee, 37232, United States
NASHVILLE, TN 372320004
Phone: (615) 343-6972
Type: Location
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: 2024-12-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241213000812 | I | Otolaryngology | MN | TBD |
| I20241213000993 | I | Otolaryngology | WI | TBD |
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.
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 55044)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O T O L A R Y N G O L O G Y | MN | |
| Otolaryngology, Plastic And Reconstructive Surgery | MN | |
| O T O L A R Y N G O L O G Y | MN | |
| O T O L A R Y N G O L O G Y | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| Qualified Audiologist | MN | |
| Qualified Audiologist | MN | |
| Qualified Audiologist | MN | |
| Nurse Practitioner | WI |
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