Jennifer A. Landry, PA-C

Physician Assistant in Portland, ME. Individual provider (NPI-1).

NPI number1790740835

StatusActive

Last updated in NPPESApr 9, 2026

Details

NPI: 1790740835
Entity type: Individual (NPI-1)
Name: Jennifer A. Landry
Credential: PA-C
Sex: Female
Sole proprietor: No
Enumeration date: Apr 20, 2006
Certification date: Apr 9, 2026
Last updated: Apr 9, 2026

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - PHYSICIAN ASSISTANT
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363A00000X	Physician Assistant	PA177	ME	Yes

Practice location

84 Marginal Way
Suite 700
Portland, ME 04101

Phone 207-774-5816 · Fax 207-523-8597

Mailing address

100 Gannett Drive
Suite C
South Portland, ME 04106

Phone 207-347-2947 · Fax 207-874-2317

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant providers in Portland, ME

All 238 Physician Assistant providers in Portland · All 7,184 providers in Portland

Checking a whole list?

Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 10 free a day, then credits from $29 for 5,000. Useful for credentialing, billing and pharmacy claim checks.

Start a bulk check