Active NPI
Wanasinghe Jayasena, P.T.
- Sports Physical Therapist
- Northfield, IL
National Provider Identifier
1336445170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 070009093
- Practice address
- 211 Waukegan Rd
Ste 300
Northfield, IL 60093-2757 - Phone
- (847) 724-7600
- NPI assigned
- Jan 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 070009093 | IL | Primary |
Addresses
Primary practice location
211 Waukegan Rd
Ste 300
Northfield, IL 60093-2757
Mailing address
211 Waukegan Rd
Ste 300
Northfield, IL 60093-2757
Phone (847) 724-7600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070009093 | IL | MD | Sports Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medcare Inc. | Sports | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Glenview, IL
- NPI 1619952298
Sports
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1336445170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 WAUKEGAN RD",
"address_2": "STE 300",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600932757",
"telephone_number": "847-724-7600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 WAUKEGAN RD",
"address_2": "STE 300",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600932757",
"telephone_number": "847-724-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYASENA",
"first_name": "WANASINGHE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-26",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "IL",
"license": "070009093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.