LANDER MEDICAL CLINIC, PC – Family Medicine Physician, NPI 1932299690
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for LANDER MEDICAL CLINIC, PC
Lander Medical Clinic, 745, Buena Vista Drive, Lander, Fremont County, Wyoming, 82520, United States
LANDER, WY 825203431
Phone: (307) 332-2941
Fax: (307) 332-1920
Type: Location
Belfast Post Office, Old Belfast Road, Lewisburg, Marshall County, Middle Tennessee, Tennessee, 37019, United States
BELFAST, ME 049159432
Phone: (307) 332-2941
Fax: (307) 332-1920
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: 2022-06-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| O20040607000680 | O | Clinic/Group Practice | WY | TBD |
| O20220512001379 | O | Clinic/Group Practice | GA | TBD |
| O20220525000662 | O | Clinic/Group Practice | NM | TBD |
| O20220526000750 | O | Clinic/Group Practice | PA | TBD |
| O20220613001856 | O | Clinic/Group Practice | AZ | 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 82520)
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