Active NPI
Gayan Sampath Wijewa Hewa Wicrama Arachchilage
- Physical Therapy Assistant
- Briarwood, NY
National Provider Identifier
1457728602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 009972-1
- Practice address
- 13938 87TH Ave
Briarwood, NY 11435-3018 - Phone
- (315) 244-4516
- NPI assigned
- Aug 24, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 009972-1 | NY | Primary |
Addresses
Primary practice location
13938 87TH Ave
Briarwood, NY 11435-3018
Mailing address
139-38 87TH Avenue
Brairwood, NY 11435
Phone (315) 244-4516
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009972-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1457728602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139-38 87TH AVENUE",
"city": "BRAIRWOOD",
"state": "NY",
"postal_code": "11435",
"telephone_number": "315-244-4516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13938 87TH AVE",
"city": "BRIARWOOD",
"state": "NY",
"postal_code": "114353018",
"telephone_number": "315-244-4516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEWA WICRAMA ARACHCHILAGE",
"first_name": "GAYAN SAMPATH WIJEWA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-24",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "009972-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Briarwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.