Individual provider Active NPI

Hugo Jayasuriya, CNA

  • Nurse's Aide
  • Ellicott City, MD
National Provider Identifier
1689381311
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
A00139732 Issued in MD
Practice address
3440 Fairfax Rd
Ellicott City, MD 21042-1696
Phone
(410) 940-9527
NPI assigned
Nov 2, 2022
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X A00139732 MD Primary

Addresses

Primary practice location

3440 Fairfax Rd
Ellicott City, MD 21042-1696

Mailing address

6036 Charles Edward Ter
Columbia, MD 21045-5096
Phone (732) 277-4490

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

State licenses

LicenseStateTypeSpecialty
A00139732MDMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1689381311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 CHARLES EDWARD TER",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455096",
            "telephone_number": "732-277-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 FAIRFAX RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421696",
            "telephone_number": "410-940-9527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYASURIYA",
        "first_name": "HUGO",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00139732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.