Gayana Wanniarachchi

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

135.001170 Issued in IL

Practice address

215 E 1St St Ste 111
Dixon, IL 61021-3198

Phone

(815) 345-5677

NPI assigned

Jul 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL HMO C-SNP
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL PPO Downstate

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Katherine Shaw Bethea Hospital

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1427043546
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113
  Care Compare affiliation
• Osf Healthcare System

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1003540220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 111",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 111",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213198",
            "telephone_number": "815-345-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNIARACHCHI",
        "first_name": "GAYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135.001170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreens
• Madison Wallace, MHP
• Donna Walls, RN QMHP
• Walmart Inc.
• Tyler Walsh, M.D.
• Warner Family Chiropractic PC
• David Russell Warner, D.C.
• Audra Danielle Washo, APN
• Muhammad Ameen Wasim, M.D.
• Burnell C Wehmeyer, MS

• Foot & Ankle Surgery Podiatrist in Dixon, IL
• Providers in Dixon, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.