Sanjaya P Sooriarachchi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N1158 Issued in TX

Practice address

1335 E Whitestone Blvd SPC 100
Cedar Park, TX 78613-7598

Phone

(512) 988-5355

Fax

(512) 465-4841

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peoples Community Clinic IncGroup PAC ID 1951337237, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 4164-sooriarachchi-sanjaya@direct.leadingreach.com
• Direct secure messaging: sanjaya.sooriarachchi@hca8.eclinicaldirectplus.com

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.

• Peoples Community Clinic Inc

  • Clinic/Center
  • Austin, TX
  • NPI 1598896391
  Medicare reassignment Care Compare group NPD
• People'S Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Manor, TX
  • NPI 1083019905
  NPD
• Burton Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Omaha, NE
  • NPI 1336140011
  NPD (past)
• Family Medicine and Surgery PC

  • General Practice Physician
  • Ralston, NE
  • NPI 1417143066
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1457442113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S CLARK ST STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606034043",
            "telephone_number": "512-988-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 E WHITESTONE BLVD SPC 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137598",
            "telephone_number": "512-988-5355",
            "fax_number": "512-465-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOORIARACHCHI",
        "first_name": "SANJAYA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198834703",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "262227YLPS",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MO",
            "identifier": "200145",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207492802",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanjaya.sooriarachchi.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "1335 E Whitestone Blvd Spc 100",
            "city": "Cedar Park",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786137598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.