Individual provider Active NPI

Dinusha Indra Bandaranayake, PA-C

  • Physician Assistant
  • Avondale, AZ
National Provider Identifier
1689136749
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57367 Issued in AZ
Practice address
10815 W McDowell Rd Ste 301
Avondale, AZ 85392-5016
Phone
(623) 433-0106
Fax
(623) 535-0741
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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 PA57367 AZ Primary

Addresses

Primary practice location

10815 W McDowell Rd Ste 301
Avondale, AZ 85392-5016

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

400 N Pepper Ave Ste 2M206
Colton, CA 92324-1801
Phone (909) 580-3474

Other practice location 2

435 N 5th St
Phoenix, AZ 85004-2157
Phone (602) 827-2420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250929002082 AZ Practitioner - Physician Assistant 2466958582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women'S Care Arizona, LLCGroup PAC ID 6103215322, 36 clinicians

Practice addresses (Care Compare)

10815 W McDowell Rd
Suite 301
Avondale, AZ 85392-5016
Phone (623) 433-0106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA57367AZMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: dinusha.bandaranayake.p1@direct.fpawomenshealth.nextgenshare.com

Organizations & group practices 1

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1689136749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD STE 301",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925016",
            "telephone_number": "623-433-0106",
            "fax_number": "623-535-0741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave Ste 2M206",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "602-827-2420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDARANAYAKE",
        "first_name": "DINUSHA",
        "middle_name": "INDRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "PA57367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.