Mr Mark J Landry, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Lafayette, Louisiana. His current practice location is
3621 Ambassador Caffery Pkwy Ste 100, Lafayette, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(337) 534-4410.
Mr Mark J Landry is licensed to practice in Louisiana (license number AP04519) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679518823.
Physician's Profile
Full Name | Mr Mark J Landry |
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Gender | Male |
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Speciality | Nurse Practitioner - Family |
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Location | 3621 Ambassador Caffery Pkwy Ste 100, Lafayette, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1679518823
- Provider Enumeration Date: 06/19/2006
- Last Update Date: 02/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 0941253504
- Enrollment ID: I20050224000661
Medical Identifiers
Medical identifiers for Mr Mark J Landry such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679518823 | NPI | - | NPPES |
1467430 | Medicaid | LA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | RN095042 (Louisiana) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP04519 (Louisiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Mark J Landry allows following entities to bill medicare on his behalf.
Entity Name | Minute Med Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750638391 PECOS PAC ID: 6103077672 Enrollment ID: O20121109000088 |
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Entity Name | Lsmd Medical Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1720623010 PECOS PAC ID: 9931537305 Enrollment ID: O20200318000564 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark J Landry is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Mark J Landry, NP 2851 Johnston St, Lafayette, LA 70503-3243 Ph: (337) 456-3519 | Mr Mark J Landry, NP 3621 Ambassador Caffery Pkwy Ste 100, Lafayette, LA 70503-5132 Ph: (337) 534-4410 |
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