Individual provider Active NPI

Thilini Lankika Goonawardena

  • Registered Nurse
  • Staten Island, NY
National Provider Identifier
1235893470
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
769103 Issued in NY
Practice address
37 Escanaba Ave
Staten Island, NY 10308-1931
Phone
(347) 995-8777
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 769103 NY Primary

Addresses

Primary practice location

37 Escanaba Ave
Staten Island, NY 10308-1931

Mailing address

37 Escanaba Ave
Staten Island, NY 10308-1931
Phone (347) 995-8777

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
769103NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1235893470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 ESCANABA AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081931",
            "telephone_number": "347-995-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 ESCANABA AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103081931",
            "telephone_number": "347-995-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOONAWARDENA",
        "first_name": "THILINI",
        "middle_name": "LANKIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "769103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.