Individual provider Active NPI

Tamara Manoji Dassanayake, M.D.

  • Obstetrics & Gynecology Physician
  • Des Moines, IA
National Provider Identifier
1487752622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
34908 Issued in IA
Practice address
330 Laurel St Ste 1100
Des Moines, IA 50314-3044
Phone
(515) 288-3287
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 34908 IA Primary

Addresses

Primary practice location

330 Laurel St Ste 1100
Des Moines, IA 50314-3044

Mailing address

330 Laurel St Ste 1100
Des Moines, IA 50314-3044
Phone (515) 288-3287

Other identifiers 1

IdentifierTypeStateIssuer
0277137MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20040701000620 IA Practitioner - Obstetrics/Gynecology 6901883578 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34908IAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa OB/GYN Specialists of Des Moines, PLC Obstetrics & Gynecology CurrentSince Nov 1, 2019 Accepting new patients
West Des Moines OB/GYN Associates, P.C. Obstetrics & Gynecology CurrentSince Sep 1, 2019 Accepting new patients
Mercy Clinics, Inc. Obstetrics & Gynecology PastSince Jan 1, 2006 Accepting new patients
Catholic Health Initiatives-Iowa Corp Past Accepting new patients

Locations

2501 Westown Pkwy
Ste 1101
West Des Moines, IA 50266
Phone (515) 267-8300

4949 Westown Pkwy
Ste 140
West Des Moines, IA 50266
Phone (515) 223-5466

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1701
  • Direct secure messaging: tdassanayake3942785@direct.trinity-health.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487752622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST STE 1100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143044",
            "telephone_number": "515-288-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAUREL ST STE 1100",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143044",
            "telephone_number": "515-288-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASSANAYAKE",
        "first_name": "TAMARA",
        "middle_name": "MANOJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "34908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0277137",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.