NPIMap

Individual provider Active NPI

Thiran Udawatta, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Bellingham, WA
National Provider Identifier
1073925087
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
MD61031268 Issued in WA
Practice address
2979 Squalicum Pkwy Ste 203
Bellingham, WA 98225-1813
Phone
(360) 733-7670
Fax
(360) 647-1901
NPI assigned
May 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD61031268 WA
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X MD61031268 WA Primary

Addresses

Primary practice location

2979 Squalicum Pkwy Ste 203
Bellingham, WA 98225-1813

Mailing address

2979 Squalicum Pkwy Ste 203
Bellingham, WA 98225-1813
Phone (360) 733-7670

Other identifiers 2

IdentifierTypeStateIssuer
2154392MedicaidWA
440477OtherWAWA LABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515000731 WA Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 0143522599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Missouri, Kansas City, School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

2979 Squalicum Pkwy
Suite 203
Bellingham, WA 98225-1813
Phone (360) 733-7670

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery CurrentSince Sep 20, 2021 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Sep 20, 2021 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

2979 Squalicum Pkwy
Ste 203
Bellingham, WA 98225
Phone (360) 733-7670

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: thiran.udawatta.p13@direct.proliance.nextgenshare.com
  • Direct secure messaging: tudawatta1033721@direct.ehre.uwmedicine.org

Organizations & group practices 4

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 4

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": "1400976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1073925087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 SQUALICUM PKWY STE 203",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251813",
            "telephone_number": "360-733-7670",
            "fax_number": "360-647-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 SQUALICUM PKWY STE 203",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251813",
            "telephone_number": "360-733-7670",
            "fax_number": "360-647-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDAWATTA",
        "first_name": "THIRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-25",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61031268",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "WA",
            "license": "MD61031268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2154392",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "440477",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.