Individual provider Active NPI

Inoka Abeysiri Devapriya, MD

  • General Practice Physician
  • Gracewood, GA
National Provider Identifier
1629463864
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
077723 Issued in GA
Practice address
100 Myrtle Blvd
103B
Gracewood, GA 30812
Phone
(706) 790-2011
NPI assigned
Apr 4, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X MT208551 PA
General Practice Physician 208D00000X 077723 GA Primary

Addresses

Primary practice location

100 Myrtle Blvd
103B
Gracewood, GA 30812

Mailing address

100 Myrtle Blvd
103B
Gracewood, GA 30812
Phone (706) 790-2011

Other practice location 1

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Other names 1

  • Miss Inoka Abeysiri Samarasekara Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191230002302 GA Practitioner - Family PracticePractitioner - General Practice 4183927346 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Medical Consulting, P.C.Group PAC ID 3678589967, 19 clinicians

Practice addresses (Care Compare)

3715 Northside Pkwy NW
Building 2 100
Atlanta, GA 30327-2822
Phone (770) 938-1757

Merit-based Incentive Payment System (MIPS)

Final score
20.57 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
68.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
077723GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Medical Consulting, P.C. CurrentSince Jan 12, 2023 Accepting new patients
Skilled Facility Health Care Solutions Inc Surgery CurrentSince Nov 18, 2019 Accepting new patients
Restored Health Inc. CurrentSince Oct 18, 2021 Accepting new patients
Tri-Med Family Care, Inc CurrentSince Aug 3, 2025 Accepting new patients

Locations

3746 Foothill Blvd
La Crescenta, CA 91214
Phone (323) 574-0387

3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757

483 Indian Trl Lilburn Rd NW
Lilburn, GA 30047
Phone (770) 279-2427

483 Indian Trl Lilburn Rd NW
#R
Lilburn, GA 30047
Phone (770) 923-4433

6120 Alabama Hwy
Ringgold, GA 30736
Phone (706) 935-5444

2000 Riveredge Pkwy
Ste 885
Sandy Springs, GA 30328
Phone (404) 941-8981

1990 Lakeside Pkwy
Ste 170
Tucker, GA 30084
Phone (770) 938-1757

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": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629463864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "address_2": "103B",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "30812",
            "telephone_number": "706-790-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "address_2": "103B",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "30812",
            "telephone_number": "706-790-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVAPRIYA",
        "first_name": "INOKA",
        "middle_name": "ABEYSIRI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT208551",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "077723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INOKA",
            "last_name": "SAMARASEKARA",
            "middle_name": "ABEYSIRI",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gracewood, GA

Sources for this page

Verify at the official NPI Registry.