Active NPI
Mahapitiyage Prith Peiris, M.D.
- Anesthesiology Physician
- Jacksonville, FL
National Provider Identifier
1407843790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME74689
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (904) 953-2000
- NPI assigned
- Oct 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | ME74689 | FL | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | ME74689 | FL | |
| Anesthesiology Physician | 207L00000X | ME74689 | FL | Primary |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050075666 | Other | FL | RAILROAD MEDICARE |
| 35549 | Other | FL | BLUECROSS/BLUESHIELD |
| 259580000 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME74689 | FL | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1407843790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "904-953-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEIRIS",
"first_name": "MAHAPITIYAGE",
"middle_name": "PRITH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-01",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "FL",
"license": "ME74689",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "FL",
"license": "ME74689",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME74689",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "050075666",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "35549",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "259580000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.