Individual provider Active NPI

Shenali Wickramanayake, DO

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1255890299
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.015546 Issued in OH
Practice address
3595 Olentangy River Rd
Columbus, OH 43214-3440
Phone
(614) 566-5414
Fax
(614) 566-6902
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.015546 OH Primary

Addresses

Primary practice location

3595 Olentangy River Rd
Columbus, OH 43214-3440

Mailing address

3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937
Phone (614) 255-6900

Other identifiers 1

IdentifierTypeStateIssuer
108390041-00MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220811003687 OH Practitioner - Internal Medicine 4284967514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Ohio Hospitalists, IncGroup PAC ID 7810985686, 194 clinicians

Practice addresses (Care Compare)

3525 Olentangy River Rd
Suite 4330
Columbus, OH 43214-3937
Phone 61425569001122

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Hospitalists, Inc CurrentSince Jun 27, 2022 Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1255890299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 OLENTANGY RIVER RD STE 4330",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143937",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143440",
            "telephone_number": "614-566-5414",
            "fax_number": "614-566-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKRAMANAYAKE",
        "first_name": "SHENALI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-07-07",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.015546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108390041-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.