Welcome To Landmark Member Registration

Provider Data Exchange

Please fill out the registration form below to set up your Landmark member account. Please note that you must provide the social security number and date of birth of the subscriber of the Landmark benefit plan on the form below. The subscriber is typically the employee of the employer group that contracted with Landmark for the benefit plan. If you wish to exchange Landmark data of a dependent of the subscriber, complete the disclosure consent form in the name of the dependent. The consent form is completed once you login to the Data Exchange Portal. If you need assistance, please call Customer Service at 800-298-4875.

Create a new account.

First Name

Last Name

Email (User-ID)

Confirm Email (User-ID)

Subscriber Social Security Number

Subscriber Date of Birth

Password

Confirm Password

Question for Password Reset

Answer