Individual provider Active NPI

Cynthia N Edirisuriya, M.D.

  • Gastroenterology Physician
  • Bordentown, NJ
National Provider Identifier
1003203464
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
25MA10372900 Issued in NJ
Practice address
100 K Johnson Blvd. N.
2ND Floor
Bordentown, NJ 08505-2275
Phone
(609) 528-8884
Fax
(609) 528-8886
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 25MA10372900 NJ Primary

Addresses

Primary practice location

100 K Johnson Blvd. N.
2ND Floor
Bordentown, NJ 08505-2275

Mailing address

100 K Johnson Blvd. N.
2ND Floor
Bordentown, NJ 08505-2275
Phone (609) 528-8884

Other practice location 1

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414
Phone (215) 955-2516

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cynthia.edirisuriya.1@12833.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210812001497 NJ Practitioner - GastroenterologyPractitioner - Internal Medicine 5294055711 Reassigns benefits to 1 organization
I20210826000532 PA Practitioner - Gastroenterology 5294055711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Drexel University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

100 K Johnson Blvd N
2ND Floor
Bordentown, NJ 08505-4713
Phone (609) 528-8884

3 Penns TRL
Newtown, PA 18940-1812
Phone (215) 504-1761

Hospital & facility affiliations

  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092
  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as apm
Quality
79.42
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy44
Upper gastrointestinal (GI) endoscopy for acid reflux63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10372900NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group Gastroenterology CurrentSince Aug 1, 2021 Accepting new patients

Locations

100 K Johnson Blvd
Fl 2
Bordentown, NJ 08505
Phone (609) 303-4300

3131 Princeton Pike
Ste 2110
Lawrenceville, NJ 08648

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

3 Penns Trl
Newtown, PA 18940
Phone (215) 504-1761

3 Penns Trl
Ste 2
Newtown, PA 18940
Phone (609) 303-4460

1050 Stony Hill Rd
Yardley, PA 19067
Phone (215) 504-1761

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1003203464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 K JOHNSON BLVD. N.",
            "address_2": "2ND FLOOR",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052275",
            "telephone_number": "609-528-8884",
            "fax_number": "609-528-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 K JOHNSON BLVD. N.",
            "address_2": "2ND FLOOR",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085052275",
            "telephone_number": "609-528-8884",
            "fax_number": "609-528-8886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074414",
            "country_code": "US",
            "telephone_number": "215-955-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDIRISURIYA",
        "first_name": "CYNTHIA",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA10372900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cynthia.edirisuriya.1@12833.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 K Johnson Blvd. N.",
            "address_2": "2nd Floor",
            "city": "Bordentown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085052275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bordentown, NJ

Sources for this page

Verify at the official NPI Registry.