Individual provider Active NPI

Mikel Angelo Alwis, M.D.

  • Family Medicine Physician
  • Barstow, CA
National Provider Identifier
1790705671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A48518 Issued in CA
Practice address
716 E Main St
Barstow, CA 92311-2354
Phone
(760) 256-6426
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A48518 CA Primary

Addresses

Primary practice location

716 E Main St
Barstow, CA 92311-2354

Mailing address

PO Box 487
Barstow, CA 92312-0487
Phone (760) 256-6426

Other names 1

  • Maithri N. Weerasinghe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050204000810 CA Practitioner - Family Practice 8527019660 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48518CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Mikel Walk in Clinic CurrentSince Aug 5, 2003 Accepting new patients
Maithri N. Weerasinghe MD Inc Family Medicine CurrentSince Sep 27, 1999 Accepting new patients
Dr.Mikel Walk in Clinic Inc Family Medicine Current Accepting new patients
Eisenhower Medical Center Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Hospital of Barstow Inc Past Accepting new patients
Corwin Medical Group Inc Ipa Family Medicine Past Accepting new patients
Inpatient Consultants of California, Inc. Past Accepting new patients
Dr, Mikel Walk in Clinic Past Accepting new patients
Victor Valley Community Hospital Past Accepting new patients

Locations

12143 Navajo Rd
Apple Valley, CA 92308
Phone (760) 240-1144

716 E Main St
Barstow, CA 92311
Phone (760) 256-6426

15791 Bear Valley Rd
Hesperia, CA 92345
Phone (760) 678-3576

15626 Hesperia Rd
Victorville, CA 92395
Phone (760) 949-1231

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790705671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923120487",
            "telephone_number": "760-256-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 E MAIN ST",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112354",
            "telephone_number": "760-256-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALWIS",
        "first_name": "MIKEL",
        "middle_name": "ANGELO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAITHRI",
            "last_name": "WEERASINGHE",
            "middle_name": "N.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Barstow, CA

Sources for this page

Verify at the official NPI Registry.