Suresh Jayantha Desilva, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

13961 Issued in NV

Practice address

21332 Nautique Blvd
Apt # 204
Cornelius, NC 28031-6410

Phone

(704) 650-3789

NPI assigned

Apr 7, 2006

Last updated

Mar 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jay Jayantha Desilva Other name

Medicare fee-for-service enrollment

Enrolled in NC, AZ, MN, NV, WI5 enrollments

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 5

Specialty

Emergency Medicine

Education

Wake Forest University School of Medicine, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Fremont Emergency Services Scherr LTDGroup PAC ID 4880684554, 135 clinicians

Cook County Hospital DistrictGroup PAC ID 4284629742, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Health Hospital, Grand Marais, MN, CCN 241317
• Langlade Hospital Hospital, Antigo, WI, CCN 521350

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Cook County Hospital District

  dba Cook County North Shore Hospital and Care Center

  • Critical Access Hospital
  • Grand Marais, MN
  • NPI 1487712493
  Medicare reassignment Care Compare group NPD
• Fremont Emergency Services Scherr LTD

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1679550149
  Medicare reassignment Care Compare group NPD
• Sampson Regional Emergency Professional Services, LLC

  • Emergency Medicine Physician
  • Clinton, NC
  • NPI 1952819575
  Medicare reassignment NPD
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  Medicare reassignment NPD
• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment NPD
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment NPD
• Sanford Health Network

  dba Sanford Jackson Medical Center

  • Critical Access Hospital
  • Jackson, MN
  • NPI 1326069097
  Medicare reassignment NPD
• South Lyon Health Center, Inc.

  dba South Lyon Medical Center

  • Critical Access Hospital
  • Yerington, NV
  • NPI 1376917302
  Medicare reassignment NPD
• South Lyon Health Center, Inc.

  dba South Lyon Medical Center

  • General Acute Care Hospital
  • Yerington, NV
  • NPI 1932160363
  Medicare reassignment NPD
• William Bee Ririe Hospital

  • Critical Access Hospital
  • Ely, NV
  • NPI 1487648804
  Medicare reassignment NPD
• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cook County Hospital District

  dba Cook County North Shore Hospital and Care Center

  • Critical Access Hospital
  • Grand Marais, MN
  • NPI 1487712493
  Care Compare affiliation
• Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin

  dba Aspirus Antigo Clinic

  • Rural Health Clinic/Center
  • Antigo, WI
  • NPI 1821151366

  Hospital

  Care Compare affiliation
• Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin

  • Critical Access Hospital
  • Antigo, WI
  • NPI 1639187412
  Care Compare affiliation

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1356304869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21332 NAUTIQUE BLVD",
            "address_2": "APT # 204",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316410",
            "telephone_number": "704-650-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21332 NAUTIQUE BLVD",
            "address_2": "APT # 204",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316410",
            "telephone_number": "704-650-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESILVA",
        "first_name": "SURESH",
        "middle_name": "JAYANTHA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "00971315",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "13961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B PROVIDER #",
            "identifier": "2246349F",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89107OL",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "DESILVA",
            "middle_name": "JAYANTHA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Elizabeth Deem, FNP
• Matt Deeringer, MED, ATC
• Nicole Degner, MSPT
• Amy Der
• Madalyn Marie Derrick, LCSW
• Stacey E Devine, M.D.
• Diabetic Special Care
• Diabetic Supply Institute Inc
• Diabetic Support Services, Inc.
• Brittany Nicole Diaconu

• Emergency Medicine Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.