Individual provider Active NPI

Medhine Anusha Wijetilleke, M.D.

  • Pediatrics Physician
  • Leesburg, VA
National Provider Identifier
1659548873
Registry record updated Dec 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101244075 Issued in VA
Practice address
163 Fort Evans Rd NE
Leesburg, VA 20176
Phone
(703) 443-2000
NPI assigned
May 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101244075 VA Primary

Addresses

Primary practice location

163 Fort Evans Rd NE
Leesburg, VA 20176

Mailing address

6287 Dunaway CT
MC Lean, VA 22101-2205

Other practice location 1

611 S Carlin Springs Rd Ste 101
Arlington, VA 22204-1061
Phone (703) 379-0704

Other identifiers 1

IdentifierTypeStateIssuer
1659548873MedicaidVA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101244075VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Loudoun Community Health Center Past Accepting new patients
Padma Wijetilleke,MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: medhine.wijetilleke@hwnova.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544227200000",
    "number": "1659548873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6287 DUNAWAY CT",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221012205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 FORT EVANS RD NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-443-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 S Carlin Springs Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222041061",
            "country_code": "US",
            "telephone_number": "703-379-0704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIJETILLEKE",
        "first_name": "MEDHINE",
        "middle_name": "ANUSHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2018-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101244075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659548873",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.