Individual provider Active NPI

Asoka Wijetilleke

  • Pediatrics Physician
  • Vero Beach, FL
National Provider Identifier
1750394987
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME23270 Issued in FL
Practice address
959 37TH PL
Vero Beach, FL 32960-6541
Phone
(772) 569-3212
Fax
(772) 569-1435
NPI assigned
Aug 15, 2006
Last updated
May 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME23270 FL Primary

Addresses

Primary practice location

959 37TH PL
Vero Beach, FL 32960-6541

Mailing address

959 37TH PL
Vero Beach, FL 32960-6541
Phone (772) 569-3212

Other identifiers 1

IdentifierTypeStateIssuer
116815200MedicaidFL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141119001700 FL Practitioner - Pediatric Medicine 1951523307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME23270FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Nov 10, 2014 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 10, 2014 Accepting new patients
Privia Medical Group Florida, LLC Past Accepting new patients
Orlando Kidney Care LLC PastSince Jul 12, 2016 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1050 37th Pl
Ste 104
Vero Beach, FL 32960
Phone (772) 978-5811

787 37th St
Ste E170
Vero Beach, FL 32960
Phone (772) 569-3212

Interoperability endpoints

  • Direct secure messaging: asoka.wijetilleke.1@8042.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1750394987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 37TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606541",
            "telephone_number": "772-569-3212",
            "fax_number": "772-569-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 37TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606541",
            "telephone_number": "772-569-3212",
            "fax_number": "772-569-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJETILLEKE",
        "first_name": "ASOKA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME23270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116815200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.