Amila Vimara Nissanka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A174462 Issued in CA

Practice address

303 Broadway St Ste 103
Laguna Beach, CA 92651-1816

Phone

(949) 665-6000

Fax

(949) 670-4967

NPI assigned

Oct 10, 2017

Last updated

May 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Emergency MedicineAlso: Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anissanka796297@direct.memorialcare.org

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

• Press Health Inc

  dba Laguna Urgent Care

  • Urgent Care Clinic/Center
  • Laguna Beach, CA
  • NPI 1083348882
  Medicare reassignment NPD Authorized official
• Press Health Inc

  dba Laguna Urgent Care

  • Family Medicine Physician
  • Laguna Beach, CA
  • NPI 1992523187
  NPD

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1073023594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 VIA LOMA",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775148",
            "telephone_number": "949-416-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BROADWAY ST STE 103",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511816",
            "telephone_number": "949-665-6000",
            "fax_number": "949-670-4967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Via Loma",
            "address_purpose": "LOCATION",
            "city": "Laguna Niguel",
            "state": "CA",
            "postal_code": "926775148",
            "country_code": "US",
            "telephone_number": "949-416-6267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISSANKA",
        "first_name": "AMILA",
        "middle_name": "VIMARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125071582",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.157093",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74854-20",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "63792",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "45836",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A174462",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125071582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Nguyen, PHARMACIST
• Kha Nguyen, PHARM.D
• Veronica F Nice, D.C.
• Tracy Nicole, D.D.S.
• Sydney Nishida
• Amir Norbaksh, D.O.
• David H. Norton, D.D.S.
• Ari J Novick, PH.D., LMFT
• Prayer Noyogiere
• Remigus Chimezie Nwaokoro, PMHNP-BC

• Family Medicine Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.