Mabodawilage Ganga Hematillake, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C149813 Issued in CA

Practice address

2907 Pleasant Valley Blvd
Altoona, PA 16602-4305

Phone

(814) 943-8164

NPI assigned

Aug 31, 2006

Last updated

Jul 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, PA2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mabodawilage.hematillake.1@17661.direct.athenahealth.com

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.

• Healthtap Medical Group, P.C.

  • General Practice Physician
  • Portola Valley, CA
  • NPI 1518330539

  PA

  Medicare reassignment NPD
• United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Huron, CA
  • NPI 1134101686
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1407967821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8017",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024305",
            "telephone_number": "814-943-8164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Santa Maria Way",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934552118",
            "country_code": "US",
            "telephone_number": "805-934-5400",
            "fax_number": "805-938-9207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEMATILLAKE",
        "first_name": "MABODAWILAGE",
        "middle_name": "GANGA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8520",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "379576-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C149813",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD428463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Helsel
• Derek Helsel
• Jason Leo Helsel, LCSW
• Jestine Marie Helsel, LBS
• Karch Connelly Helsel, PHARMD
• Layla Irene Hendricks, LSW
• Kristopher Mathew Henninger
• Henry D. McKinney, M.D.
• Theresa Henry, RD, LDN
• Allison Herbaugh

• Internal Medicine Physician in Altoona, PA
• Providers in Altoona, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.