NPIMap

Individual provider Active NPI

Kosala Samarasinghe, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1386626034
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A80809 Issued in CA
Practice address
501 Washington St
San Diego, CA 92103-2231
Phone
(619) 278-3340
Fax
(619) 278-3335
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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 A80809 CA Primary

Addresses

Primary practice location

501 Washington St
San Diego, CA 92103-2231

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (619) 278-3340

Other identifiers 1

IdentifierTypeStateIssuer
00A808090MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805001686 CA Practitioner - Internal Medicine 1658342142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

501 Washington St
Suite 600
San Diego, CA 92103-2239
Phone (619) 278-3300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80809CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Internal Medicine CurrentSince May 6, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince May 6, 2013 Accepting new patients
Scripps Health Past Accepting new patients
Sheridan Drive Medical Group LLP Internal Medicine PastSince Aug 1, 2014 Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

501 Washington St
Ste 600
San Diego, CA 92103
Phone (619) 278-3300

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

6386 Alvarado Ct
Ste 310
San Diego, CA 92120
Phone (619) 229-5055

501 Washington St
San Diego, CA 92103
Phone (619) 278-3300

Interoperability endpoints

  • FHIR API: https://fhir.medent.com/fhir/R4/3P171181
  • Direct secure messaging: ksamarasinghe19161@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1386626034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-278-3340",
            "fax_number": "619-278-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-278-3340",
            "fax_number": "619-278-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARASINGHE",
        "first_name": "KOSALA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A808090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.