NPIMap

Individual provider Active NPI

Nilukshan Ranil Sirigampola, PA-C, ATC

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1497135230
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9114956 Issued in FL
Practice address
25 W Crystal Lake St
Orlando, FL 32806-4475
Phone
(407) 254-2500
NPI assigned
Jun 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA9114956 FL
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA9114956 FL Primary

Addresses

Primary practice location

25 W Crystal Lake St
Orlando, FL 32806-4475

Mailing address

25 W Crystal Lake St
Orlando, FL 32806-4475
Phone (407) 254-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211014000437 FL Practitioner - Physician Assistant 1355749847 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

25 S Terry Ave
Suite 320
Orlando, FL 32805-1843
Phone (844) 407-4070

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 422-4971

410 Lionel Way
Davenport, FL 33837-7809

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
77.92
Promoting interoperability
99
Improvement activities
40
Cost
79.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9114956FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Multi-Specialty CurrentSince Oct 23, 2023 Accepting new patients
Rothman Orthopaedics of Florida,PLLC CurrentSince Nov 6, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 23, 2023 Accepting new patients
Cora Health Services, Inc Past Accepting new patients
Cora Health Services, Inc Multi-Specialty Past Accepting new patients

Locations

604 Oak Commons Blvd
Kissimmee, FL 34741
Phone (407) 846-6004

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1497135230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064475",
            "telephone_number": "407-254-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W CRYSTAL LAKE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328064475",
            "telephone_number": "407-254-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIGAMPOLA",
        "first_name": "NILUKSHAN",
        "middle_name": "RANIL",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-07",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114956",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9114956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.