Individual provider Active NPI

Chanaka Dinesha Wickramasinghe, M.D

  • Cardiovascular Disease Physician
  • Rancho Mirage, CA
National Provider Identifier
1174840680
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A130331 Issued in CA
Practice address
39000 Bob Hope Drive
Hal B. Wallis BLDG
Rancho Mirage, CA 92270-3221
Phone
(760) 346-0642
Fax
(760) 340-9142
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A130331 CA Primary

Addresses

Primary practice location

39000 Bob Hope Drive
Hal B. Wallis BLDG
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Drive
Hal B. Wallis BLDG
Rancho Mirage, CA 92270-3221
Phone (760) 346-0642

Other practice location 1

5201 Harry Hines Blvd
Graduate Medical Education
Dallas, TX 75235-7708
Phone (214) 590-8058

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170825001981 CA Practitioner - Cardiovascular Disease (Cardiology) 8123390101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 773-2030

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243
  • Palo Verde Hospital Hospital, Blythe, CA, CCN 051339

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
85.37
Promoting interoperability
100
Improvement activities
40
Cost
74.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal266

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130331CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Aug 14, 2017 Accepting new patients
Eisenhower Medical Center CurrentSince Nov 15, 2020 Accepting new patients
Eisenhower Medical Center CurrentSince Aug 14, 2017 Accepting new patients

Locations

39000 Bob Hope Dr
#B
Rancho Mirage, CA 92270
Phone (760) 346-0642

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

Interoperability endpoints

  • Direct secure messaging: cwickramasinghe77632@edirect.emc.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174840680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DRIVE",
            "address_2": "HAL B. WALLIS BLDG",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DRIVE",
            "address_2": "HAL B. WALLIS BLDG",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-346-0642",
            "fax_number": "760-340-9142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Harry Hines Blvd",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357708",
            "country_code": "US",
            "telephone_number": "214-590-8058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICKRAMASINGHE",
        "first_name": "CHANAKA",
        "middle_name": "DINESHA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A130331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.