Active NPI
Malithi Jayasundara, MD
- Rheumatology Physician
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 2021-00789
- Practice address
- 2421 Silver Stream LN
Wilmington, NC 28401-7684 - Phone
- (910) 815-7421
- Fax
- (910) 341-1900
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD21626 | ME | |
| Internal Medicine Physician | 207R00000X | 125061104 | IL | |
| Rheumatology Physician | 207RR0500X | 2021-00789 | NC | Primary |
Addresses
Primary practice location
2421 Silver Stream LN
Wilmington, NC 28401-7684
Mailing address
1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2021-00789 | Other | NC | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone (910) 341-1540
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125061104 | IL | MD | Internal Medicine Physician |
| MD21626 | ME | MD | Internal Medicine Physician |
| 2021-00789 | NC | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergeortho PA | Current | Accepting new patients | |
| Emergeortho PA | Rheumatology | Current | Accepting new patients |
| Wilmington ASC LLC | Current | Accepting new patients | |
| Wilmington Health PLLC | Current | Accepting new patients | |
| Wha Medical Clinic PLLC | Current | Accepting new patients |
Locations
100 Perkins Dr
Chapel Hill, NC 27514
Phone (919) 942-3171
7810 NC 751 Hwy
Durham, NC 27713
Phone (919) 544-7270
7810 NC 751 Hwy
Ste 150
Durham, NC 27713
Phone (919) 544-7270
799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079
2421 Silver Stream Ln
Wilmington, NC 28401
Phone (910) 763-2072
1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705
Interoperability endpoints
- malithi.jayasundara.p1@direct.wilmingtonhealth.nextgenshare.com
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Wilmington, NC
- NPI 1881632339
-
- Durable Medical Equipment & Medical Supplies
- Eden, NC
- NPI 1841170222
-
- Endoscopy Clinic/Center
- Wilmington, NC
- NPI 1083889091
-
dba Wilmington Health Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Wilmington, NC
- NPI 1548456478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1871849976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 MEDICAL CENTER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017307",
"telephone_number": "910-341-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2421 SILVER STREAM LN",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017684",
"telephone_number": "910-815-7421",
"fax_number": "910-341-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYASUNDARA",
"first_name": "MALITHI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ME",
"license": "MD21626",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125061104",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NC",
"license": "2021-00789",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "2021-00789",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.