Dilantha B. Ellegala, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

54678 Issued in AZ

Practice address

4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718

Phone

(602) 462-0469

Fax

(602) 635-3846

NPI assigned

Nov 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

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 2

Specialty

Neurosurgery

Education

University of Washington School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002
• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1437529245
  Medicare reassignment Care Compare group NPD
• Advanced Spine and Pain LLC

  • Interventional Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1356950653

  Neurological Surgery

  Medicare reassignment NPD
• Acute Care Surgical Affiliates of Texas PA

  • Surgery Physician
  • Corpus Christi, TX
  • NPI 1407322415
  Medicare reassignment NPD
• Neurosurgical Affiliates of Texas, PA

  • Neurological Surgery Physician
  • Corpus Christi, TX
  • NPI 1437935137
  Medicare reassignment NPD
• Advanced Spine and Pain LLC

  • Pain Medicine (Anesthesiology) Physician
  • Phoenix, AZ
  • NPI 1639951577
  NPD
• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Maricopa, AZ
  • NPI 1063887727
  NPD
• Banner - University Physician Specialists LLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1164255865
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1710056080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE 308",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E CAMELBACK RD STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182718",
            "telephone_number": "602-462-0469",
            "fax_number": "602-635-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5310 W Thunderbird Rd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064710",
            "country_code": "US",
            "telephone_number": "602-462-0469",
            "fax_number": "602-635-3846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLEGALA",
        "first_name": "DILANTHA",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "VA",
            "license": "0101250836",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "54678",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "MD26843",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OR",
            "license": "LL15652",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Elizalde, APRN-CNP, PMHNP-BC
• Alma Cecilia Elizarraraz
• Mohammed Elkhwad, MD
• Shavaughn E Elkins, MSRLS-CTRS
• Rawan Elkurdi, MD
• Sadie Ellenson, MD
• Evan B Eller, M.D.
• Vanessa Fernandez Eller, MD
• Lee Ellershaw, PHARM D.
• William Ellert, MD

• Neurological Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Neurological Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.