Individual provider Active NPI

Upulie Nawaratne, MD

  • Pediatric Critical Care Medicine Physician
  • Houston, TX
National Provider Identifier
1114105038
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
S2852 Issued in TX
Practice address
6400 Fannin St
Houston, TX 77030-1521
Phone
(713) 500-6443
NPI assigned
Feb 1, 2008
Last updated
Nov 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 046155 CT
Pediatrics Physician 208000000X E-11454 AR
Pediatric Cardiology Physician 2080P0202X E-11454 AR
Pediatric Critical Care Medicine Physician 2080P0203X S2852 TX Primary

Addresses

Primary practice location

6400 Fannin St
Houston, TX 77030-1521

Mailing address

1133 John Freeman Blvd # 205N
Houston, TX 77030-2809
Phone (713) 500-6443

Other practice location 1

80 Phoenix Ave
Suite 201
Waterbury, CT 06702-1418
Phone (203) 756-8021 ext. 3085

Other practice location 2

1 Childrens Way # 512-3
Little Rock, AR 72202
Phone (501) 364-1479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20191023002598 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 3971673773 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Sep 24, 2019 Accepting new patients
Ut Physicians CurrentSince Sep 24, 2019 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

6400 Fannin St
Houston, TX 77030
Phone (713) 704-4300

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

Interoperability endpoints

  • Direct secure messaging: unawaratne@direct.wtbyhosp.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1114105038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 JOHN FREEMAN BLVD # 205N",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302809",
            "telephone_number": "713-500-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301521",
            "telephone_number": "713-500-6443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Phoenix Ave",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021418",
            "country_code": "US",
            "telephone_number": "203-756-8021 x3085",
            "fax_number": "203-596-9038",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Way # 512-3",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "72202",
            "country_code": "US",
            "telephone_number": "501-364-1479",
            "fax_number": "501-364-3667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAWARATNE",
        "first_name": "UPULIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "046155",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-11454",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AR",
            "license": "E-11454",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "S2852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.