Nisal K Samarasekera, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23001 Issued in AZ

Practice address

6320 W Union Hills Dr Ste A210
Glendale, AZ 85308-7212

Phone

(623) 362-8866

Fax

(623) 362-8867

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Supportive Care, LLC

  • Specialist
  • Phoenix, AZ
  • NPI 1710279385
  Medicare reassignment NPD
• Hospice of the Valley

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1588682405

  Family Medicine

  Medicare reassignment NPD
• Arrowhead Family Care, P.C.

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1750550265
  NPD
• Hospice of the Valley

  • Community Based Hospice Care Agency
  • Scottsdale, AZ
  • NPI 1528086451

  Family Medicine

  NPD

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1841258902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE A210",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087212",
            "telephone_number": "623-362-8866",
            "fax_number": "623-362-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR STE A210",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087212",
            "telephone_number": "623-362-8866",
            "fax_number": "623-362-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARASEKERA",
        "first_name": "NISAL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Salwin, D.D.S.
• Sam Understands Counseling, LLC (LifeTree Counseling)
• Elizabeth Sam
• Sam's Club Optical (Sam's Club Optical 30-4732)
• Shimran Samantaray
• Allyson Sambach, DNP, PMHNP-BC
• Jessica Icha Sambrano, MS, LAC
• Samer Makhoul MD PLLC
• Sammah Behavioral Health LLC
• Sammy Zakhary MD PC

• Family Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.