Individual provider Active NPI

Chandrini Menka Jayasundera, MD

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1316143407
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M7302 Issued in TX
Practice address
313 E 12TH St
Austin, TX 78701-1954
Phone
(409) 772-0848
NPI assigned
Jun 25, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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 M7302 TX Primary

Addresses

Primary practice location

313 E 12TH St
Austin, TX 78701-1954

Mailing address

313 E 12TH St
Austin, TX 78701-1954
Phone (409) 772-0848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070801000601 TX Practitioner - Internal Medicine 5799876074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1400 N Ih 35
300 Tri County Practice Association
Austin, TX 78701-1926
Phone (512) 324-8300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Feb 1, 2014 Accepting new patients
Seton Family of Doctors Internal Medicine CurrentSince Feb 1, 2014 Accepting new patients
Ascension Seton Past Accepting new patients
University of Texas Medical Branch, Austin Initiatives at Utmb Internal Medicine Past Accepting new patients

Locations

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

4616 W Howard Ln
Austin, TX 78728
Phone (224) 558-8613

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1316143407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 E 12TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011954",
            "telephone_number": "409-772-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 E 12TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011954",
            "telephone_number": "409-772-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYASUNDERA",
        "first_name": "CHANDRINI",
        "middle_name": "MENKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.