Individual provider Active NPI

Himali Jayakody, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Oldsmar, FL
National Provider Identifier
1346479854
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME119541 Issued in FL
Practice address
170 Pine Ave N
Oldsmar, FL 34677-4629
Phone
(480) 652-2110
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R- 8547 IA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME119541 FL Primary

Addresses

Primary practice location

170 Pine Ave N
Oldsmar, FL 34677-4629

Mailing address

170 Pine Ave N
Oldsmar, FL 34677-4629
Phone (813) 553-4448

Other practice location 1

2 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 821-8038

Other identifiers 2

IdentifierTypeStateIssuer
105381800MedicaidFL
I4V0MOtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hjayakody130507@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240826003952 FL Practitioner - NeurologyPractitioner - Epileptologists 0042759748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Epileptologists
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

170 Pine Ave N
Oldsmar, FL 34677-4629
Phone (813) 553-4448

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R- 8547IAMDPediatrics Physician
ME119541FLMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Pediatric Neurocare Institute LLC Neurology With Special Qualifications in Child Neurology CurrentSince Apr 8, 2024 Accepting new patients

Locations

170 Pine Ave N
Oldsmar, FL 34677
Phone (480) 652-2110

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1346479854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PINE AVE N",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774629",
            "telephone_number": "813-553-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PINE AVE N",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774629",
            "telephone_number": "480-652-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-821-8038",
            "fax_number": "813-974-0483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYAKODY",
        "first_name": "HIMALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R- 8547",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME119541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105381800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "I4V0M",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hjayakody130507@direct.tgh.org",
            "affiliation": "N",
            "address_1": "2 Tampa General Cir",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

Verify at the official NPI Registry.