Individual provider Active NPI

Isuru Udayanga Wijesinghe, D.O.

  • Anesthesiology Physician
  • Johnson City, NY
National Provider Identifier
1275977019
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
293869 Issued in NY
Practice address
156 Corliss Ave
Ste 107
Johnson City, NY 13790
Phone
(607) 763-6735
NPI assigned
Apr 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A14005 CA
Anesthesiology Physician 207L00000X 293869 NY Primary

Addresses

Primary practice location

156 Corliss Ave
Ste 107
Johnson City, NY 13790

Mailing address

156 Corliss Ave
Ste 107
Johnson City, NY 13790
Phone (607) 763-6735

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
I20220629003551 CA Practitioner - Anesthesiology 6406118777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Springs Anesthesia Services PCGroup PAC ID 6406049592, 90 clinicians

Practice addresses (Care Compare)

1600 N Rose Ave
Oxnard, CA 93030-3722
Phone (805) 988-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49.94 of 100Reported as group
Quality
38.91
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14005CAMDAcupuncturist
20A14005CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Springs Anesthesia Services, PC Anesthesiology CurrentSince Nov 2, 2022 Accepting new patients
Ventura Anesthesia Medical Group Anesthesiology CurrentSince Apr 1, 2022 Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

1050 Linden Ave
Long Beach, CA 90813
Phone (562) 491-9000

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

415 E Harding Way
Ste E
Stockton, CA 95204
Phone (209) 337-4935

3116 W March Ln
Ste 200
Stockton, CA 95219
Phone (510) 537-1234

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

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 1

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1275977019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE",
            "address_2": "STE 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-763-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 CORLISS AVE",
            "address_2": "STE 107",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-763-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJESINGHE",
        "first_name": "ISURU",
        "middle_name": "UDAYANGA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A14005",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "293869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.