Individual provider Active NPI

Achala Shivanthi Gunasena, PA-C

  • Physician Assistant
  • Frederick, MD
National Provider Identifier
1497282610
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006440 Issued in MD
Practice address
7211 Bank CT
Frederick, MD 21703-8483
Phone
(240) 215-6310
Fax
(240) 566-7754
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0006440 MD Primary

Addresses

Primary practice location

7211 Bank CT
Frederick, MD 21703-8483

Mailing address

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170822001272 MD Practitioner - Physician Assistant 4385916683 Reassigns benefits to 2 organizations
I20171218000342 DC Practitioner - Physician Assistant 4385916683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frederick Health Hospital IncGroup PAC ID 0446149256, shared by 8 NPIs, 127 clinicians

Practice addresses (Care Compare)

1194 Dutchmans Creek Dr
Brunswick, MD 21716-9786
Phone (240) 215-6310

3000 D Ventrie CT
Myersville, MD 21773-7817
Phone (240) 215-6310

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

7211 Bank CT
Frederick, MD 21703-8482
Phone (240) 215-6310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Aug 12, 2024 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 9, 2018 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Aug 12, 2024 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 9, 2018 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Jun 21, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Jun 21, 2017 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 9, 2018 Accepting new patients
MNR Industries, LLC CurrentSince Oct 10, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

5 Bel Air South Pkwy
Ste 1535
Bel Air, MD 21015
Phone (410) 569-0044

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

7211 Bank Ct
Ste 230
Frederick, MD 21703
Phone (240) 415-5020

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1497282610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-215-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 BANK CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038483",
            "telephone_number": "240-215-6310",
            "fax_number": "240-566-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNASENA",
        "first_name": "ACHALA",
        "middle_name": "SHIVANTHI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.