Buddhika Abeyratne – Physician Assistant

Key facts

NPI: 1104369560
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
Practice address: 3475 N Saratoga St
Oak Harbor, WA 98278-2652
Phone: (360) 257-9794
NPI assigned: Dec 2, 2016
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X			Yes

Addresses

Primary practice location

3475 N Saratoga St
Oak Harbor, WA 98278-2652

Mailing address

5422 Prince Dr
Lake Dallas, TX 75065-2652
Phone (940) 368-8651

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2024.

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1104369560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5422 PRINCE DR",
            "city": "LAKE DALLAS",
            "state": "TX",
            "postal_code": "750652652",
            "telephone_number": "940-368-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 N SARATOGA ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982782652",
            "telephone_number": "360-257-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEYRATNE",
        "first_name": "BUDDHIKA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-02",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

All providers in Oak Harbor, WA · Physician Assistant in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.