SANDRA C. LANDRY (PA-C) – Physician Assistant, NPI 1104925734
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
773 PHYSICIAN ASSISTANT in RI
Provider Addresses for SANDRA C. LANDRY (PA-C)
2 Dudley St
Providence, RI 029053236
Phone: (401) 444-5891
Fax: (401) 444-8158
Type: Location
Charlton Memorial Hospital, 363, Highland Avenue, Fall River Station, Fall River, Bristol County, Massachusetts, 02720, United States
FALL RIVER, MA 027203703
Phone: (508) 973-7018
Fax: (508) 973-7147
Type: Location
200, Mill Road, Fairhaven, Bristol County, Massachusetts, 02719, United States
SUITE 180
FAIRHAVEN, MA 027195252
Phone: (508) 973-2000
Fax: (508) 973-2001
Type: Mailing
593 EDDY ST
PROVIDENCE, RI 029034923
Phone: (401) 444-7585
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: 2023-02-16
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 |
|---|---|---|---|---|
| I20041203000048 | I | Physician Assistant | MA | TBD |
| I20230216002471 | I | Physician Assistant | RI | 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 02905)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | RI | |
| - | RI | |
| Internal Medicine | RI | |
| Internal Medicine | RI | |
| - | RI | |
| Internal Medicine | RI | |
| P S Y C H I A T R Y | MI | |
| - | RI | |
| - | RI | |
| P S Y C H I A T R Y | RI |
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