Kanista Menike Basnayake, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

189498 Issued in NY

Practice address

365 E Main St
South Brookhaven Health Center West
Patchogue, NY 11772-3145

Phone

(631) 854-1281

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Nassau University Health Corporation

  • General Acute Care Hospital
  • East Patchogue, NY
  • NPI 1598993370
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336221233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ESPLANADE DR",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117727905",
            "telephone_number": "631-758-6773",
            "fax_number": "631-758-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 E MAIN ST",
            "address_2": "SOUTH BROOKHAVEN HEALTH CENTER WEST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723145",
            "telephone_number": "631-854-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASNAYAKE",
        "first_name": "KANISTA",
        "middle_name": "MENIKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "189498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward John Barnoski, PH.D.
• Julianna Baron
• Annette Rose Barone, R.N.
• Kathleen Barry, LCSW
• Robert Basedow
• Sarah Battaglia
• Alexandra Faith Baumann
• Paula S Baumer, LMSW
• Marilyn Claire Baxter, RN
• Mustafa Bayram, PMHNP-BC

• Family Medicine Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.