Ian Goonewardene, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD064260L Issued in PA

Practice address

420 S 5TH Ave
West Reading, PA 19611-2143

Phone

(484) 628-5455

NPI assigned

May 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Chestnut Hill Clinic Company, LLC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1508936071
  Medicare reassignment NPD
• Tower Health Medical Group

  • Internal Medicine Physician
  • Birdsboro, PA
  • NPI 1609291350
  Medicare reassignment NPD
• Chestnut Hill Clinic Company, LLC

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1811611692
  NPD
• Tower Health Medical Group

  • Vascular Surgery Physician
  • West Reading, PA
  • NPI 1780986901
  NPD
• Tower Health Medical Group

  • Surgery Physician
  • Wyomissing, PA
  • NPI 1831954353
  NPD

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1679522676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-5455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6th Ave & Spruce St",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "19611",
            "country_code": "US",
            "telephone_number": "610-988-5455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOONEWARDENE",
        "first_name": "IAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD064260L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001709312",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Godown, PA
• Alejandro Gomez
• Muhammad Umer Riaz Gondal
• Kolin Diane Good, M.D.
• Beth Goodman
• Sahithi Gosala, M.D.
• Vaibhav Goswami, MD
• Katherine Elizabeth Goth, M.D.
• Anna M Grassi, DO
• Erin Kathleen Mack Graves, M.D.

• Internal Medicine Physician in West Reading, PA
• Providers in West Reading, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.