Individual provider Active NPI

Senaka Y. Ratnayake, MD

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1194108670
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01078683A Issued in IN
Practice address
714 N Michigan St
South Bend, IN 46601
Phone
(574) 647-7477
Fax
(574) 647-3655
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11018128A IN
Family Medicine Physician 207Q00000X 01078683A IN Primary

Addresses

Primary practice location

714 N Michigan St
South Bend, IN 46601

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924
Phone (574) 647-1610

Other identifiers 1

IdentifierTypeStateIssuer
300013891MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180711002263 IN Practitioner - Family Practice 9335452556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hancock Physician Network LLCGroup PAC ID 8325952633, 139 clinicians

Practice addresses (Care Compare)

120 W McKenzie Rd
Suite H
Greenfield, IN 46140-1072
Phone (317) 462-2335

Hospital & facility affiliations

  • Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
  • Hancock Regional Hospital Hospital, Greenfield, IN, CCN 150037

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Physician Network, LLC Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

120 W McKenzie Rd
Ste H
Greenfield, IN 46140
Phone (317) 462-2335

801 N State St
Ste 2000
Greenfield, IN 46140
Phone (317) 325-2727

Organizations & group practices 2

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 2

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1194108670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-647-7477",
            "fax_number": "574-647-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATNAYAKE",
        "first_name": "SENAKA",
        "middle_name": "Y.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11018128A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01078683A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300013891",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.