NPIMap

Individual provider Active NPI

Kasuni Kotelawala, MD

  • Family Medicine Physician
  • Glens Falls, NY
National Provider Identifier
1801327119
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
306276 Issued in NY
Practice address
38 Larose St
Glens Falls, NY 12801-3452
Phone
(518) 824-8181
Fax
(833) 819-0268
NPI assigned
Mar 27, 2017
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 306276 NY Primary

Addresses

Primary practice location

38 Larose St
Glens Falls, NY 12801-3452

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

Other identifiers 1

IdentifierTypeStateIssuer
06157006MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kasuni.kotelawala.1@1823.direct.athenahealth.com
Direct Messaging Address kasuni.kotelawala.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200827001855 NY Practitioner - Family Practice 8224377817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306276NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network CurrentSince Sep 14, 2020 Accepting new patients
Hudson Headwaters Health Network Family Medicine Current Accepting new patients
Hudson Headwaters Health Network Family Medicine CurrentSince Sep 14, 2020 Accepting new patients

Locations

38 Larose St
Glens Falls, NY 12801
Phone (518) 824-8181

161 Carey Rd
Queensbury, NY 12804
Phone (518) 480-0011

9 Carey Rd
Queensbury, NY 12804

Interoperability endpoints

  • Direct secure messaging: kasuni.kotelawala.1@1823.direct.athenahealth.com

Organizations & group practices 3

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1801327119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 LAROSE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013452",
            "telephone_number": "518-824-8181",
            "fax_number": "833-819-0268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Carey Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128047821",
            "country_code": "US",
            "telephone_number": "518-824-8610",
            "fax_number": "518-824-2390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTELAWALA",
        "first_name": "KASUNI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "306276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06157006",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kasuni.kotelawala.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "161 Carey Rd",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128047821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kasuni.kotelawala.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "38 Larose St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128013452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.