Active NPI
L. Gayani Tillekeratne, MD
- Infectious Disease Physician
- Philadelphia, PA
National Provider Identifier
1730382953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- MT190497
- Practice address
- 3400 Spruce St
3 Silverstein Suite E
Philadelphia, PA 19104-4206 - Phone
- (215) 662-2200
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | MT190497 | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
3 Silverstein Suite E
Philadelphia, PA 19104-4206
Mailing address
3400 Spruce St
3 Silverstein Suite E
Philadelphia, PA 19104-4206
Phone (215) 662-2200
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT190497 | PA | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335398400000",
"number": "1730382953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "3 SILVERSTEIN SUITE E",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "3 SILVERSTEIN SUITE E",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEKERATNE",
"first_name": "L. GAYANI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2012-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "PA",
"license": "MT190497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.