JERONE THEODORE LANDSTROM M.D. NPI 1255407953

NPI Information

  • NPI: 1255407953
  • Provider Name: JERONE THEODORE LANDSTROM, M.D.
  • Classification: Surgery - 2086S0105X
  • Specialization: Surgery of the Hand
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 633 GOV CARLOS CAMACHO ROAD
    SUITE 104 GUAM MEDICAL PLAZA
    TAMUNING, GU
    ZIP 96913
  • Phone: (671) 646-4263

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NPI Details

Jerone Theodore Landstrom, M.D. is a surgery of the hand surgery in Tamuning, GU with 44 years of experience. The provider is a surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. Jerone Theodore Landstrom, M.D. NPI is 1255407953. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1981

The provider's business location address is:

633 GOV CARLOS CAMACHO ROAD
SUITE 104 GUAM MEDICAL PLAZA
TAMUNING, GU
ZIP 96913
Phone: (671) 646-4263
Fax: (671) 649-1019

The NPI 1255407953 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection into tendon or ligament (HCPCS:20550)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 60-74 minutes (HCPCS:99205)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Application of nonmoveable forearm to hand splint (HCPCS:29125)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Injection into tendon at attachment to bone or muscle (HCPCS:20551)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Upper limb (arm) arthroscopy (minimally invasive joint repair) (HCPCS:NAN17)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 11/27/2006 and was last updated on 4/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryM-958GUAMNo
22086S0105XSurgerySurgery of the HandM00958GUAMYes
32086S0105XSurgerySurgery of the HandMD9588HAWAIINo
42086S0105XSurgerySurgery of the HandJ9150TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1J6266501MEDICAIDTEXAS
20005867019OTHERAETNA
3170804300OTHERUSDOL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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