Individual provider Active NPI

Ruvini Wijetilaka, M.D

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1194003582
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
295042 Issued in NY
Practice address
99 John St
New York, NY 10038-2903
Phone
(201) 747-1141
Fax
(646) 396-5651
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD459542 PA
Internal Medicine Physician 207R00000X 295042 NY Primary
Internal Medicine Physician 207R00000X 181453 CA

Addresses

Primary practice location

99 John St
New York, NY 10038-2903

Mailing address

99 John St
New York, NY 10038-2903
Phone (201) 747-1141

Other practice location 1

8550 Santa Monica Blvd Fl 2
West Hollywood, CA 90069-4496
Phone (833) 447-2775

Other practice location 2

126 5th Ave
New York, NY 10011-5606
Phone (833) 477-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2019 through Jul 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181453CAMDInternal Medicine Physician
MD459542PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parsley Medical PC Past Accepting new patients
Infinite Wellness Medical PC PastSince Sep 17, 2018 Accepting new patients
Parsley Medical PLLC Past Accepting new patients
Duane Reade PastSince Apr 13, 2025 Accepting new patients
Cloud Health Medical Group of California, P.C. Internal Medicine Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1194003582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JOHN ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382903",
            "telephone_number": "201-747-1141",
            "fax_number": "646-396-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 JOHN ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382903",
            "telephone_number": "201-747-1141",
            "fax_number": "646-396-5651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8550 Santa Monica Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900694496",
            "country_code": "US",
            "telephone_number": "833-447-2775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "126 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100115606",
            "country_code": "US",
            "telephone_number": "833-477-2775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIJETILAKA",
        "first_name": "RUVINI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD459542",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "295042",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "181453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.