Individual provider Active NPI

Isuri Weerasinghe, MPAS, MPH, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1710423884
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11084 Issued in TX
Practice address
815 Pennsylvania Ave
Fort Worth, TX 76104
Phone
(817) 321-0404
NPI assigned
Jan 13, 2017
Last updated
Jun 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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 PA11084 TX Primary

Addresses

Primary practice location

815 Pennsylvania Ave
Fort Worth, TX 76104

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146
Phone (817) 321-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170406000124 TX Practitioner - Physician Assistant 8022394063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

17980 Dallas Pkwy
Suite 200
Dallas, TX 75287-6817
Phone (817) 321-0937

6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (214) 590-8000

8200 Walnut Hill Lane
TH Presbyterian Hospital of Dallas
Dallas, TX 75231-4426
Phone (214) 345-6789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA11084TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 5, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 5, 2024 Accepting new patients
Radiology Associates of North Texas PA CurrentSince Mar 27, 2017 Accepting new patients
Radiology Associates of North Texas, PA CurrentSince Mar 27, 2017 Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

1622 8th Ave
Ste 120
Fort Worth, TX 76104
Phone (817) 923-8220

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

5425 W Spring Creek Pkwy
Plano, TX 75024
Phone (972) 599-9600

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

1814 Roseland Blvd
Ste 100
Tyler, TX 75701
Phone (214) 696-8033

5303 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-2300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1710423884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-321-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEERASINGHE",
        "first_name": "ISURI",
        "credential": "MPAS, MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.