NPIMap

Individual provider Active NPI

Surendranath P Ekanayake, MD

  • Obstetrics & Gynecology Physician
  • Cumberland, MD
National Provider Identifier
1831175173
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D54964 Issued in MD
Practice address
12502 Willowbrook Rd
Suite 550
Cumberland, MD 21502-6491
Phone
(301) 723-3940
Fax
(301) 723-3941
NPI assigned
Dec 19, 2005
Last updated
Oct 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D54964 MD Primary

Addresses

Primary practice location

12502 Willowbrook Rd
Suite 550
Cumberland, MD 21502-6491

Mailing address

109 Rayloc Dr
Hancock, MD 21750-1518
Phone (301) 678-5187

Other identifiers 6

IdentifierTypeStateIssuer
3810005772MedicaidWV
211849OtherMDMEDICARE FQHC
1007288800008MedicaidPA
482501200MedicaidMD
188838001MedicaidTX
8G7178OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20040609000184 MD Practitioner - Obstetrics/Gynecology 6709869019 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12502 Willowbrook Rd
Suite 550
Cumberland, MD 21502-6594
Phone (301) 723-3940

130 W High St
Hancock, MD 21750-1143
Phone (301) 678-7256

7601 Osler Dr
Towson, MD 21204-7700
Phone (410) 337-4877

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Nov 10, 2021 Accepting new patients
Tri-State Community Health Center, Inc CurrentSince Feb 22, 2013 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Tri-State Community Health Center, Inc CurrentSince Feb 22, 2013 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 21, 2021 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Sep 21, 2021 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Nov 10, 2021 Accepting new patients
Sinai Hospital of Baltimore Inc Obstetrics & Gynecology CurrentSince Jul 1, 2013 Accepting new patients
St. Agnes Healthcare, Inc. Past Accepting new patients
Tri-State Community Health Center, Inc Past Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients

Locations

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

2435 W Belvedere Ave
#S22
Baltimore, MD 21215
Phone (410) 578-6855

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

12502 Willowbrook Rd
Ste 550
Cumberland, MD 21502
Phone (301) 723-3940

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

109 Rayloc Dr
Hancock, MD 21750
Phone (301) 678-5187

130 W High St
Hancock, MD 21750
Phone (301) 678-7256

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

Organizations & group practices 12

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 4

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1831175173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RAYLOC DR",
            "city": "HANCOCK",
            "state": "MD",
            "postal_code": "217501518",
            "telephone_number": "301-678-5187",
            "fax_number": "301-678-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 WILLOWBROOK RD",
            "address_2": "SUITE 550",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026491",
            "telephone_number": "301-723-3940",
            "fax_number": "301-723-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKANAYAKE",
        "first_name": "SURENDRANATH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D54964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005772",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "211849",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288800008",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482501200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188838001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G7178",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.