Individual provider Active NPI

Malithi Jayasundara, MD

  • Rheumatology Physician
  • Wilmington, NC
National Provider Identifier
1871849976
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
2021-00789 Issued in NC
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

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2021-00789OtherNCMEDICAL 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415002853 NC Practitioner - Rheumatology 8123349024 Reassigns benefits to 2 organizations

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
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

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

LicenseStateTypeSpecialty
125061104ILMDInternal Medicine Physician
MD21626MEMDInternal Medicine Physician
2021-00789NCMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Apr 1, 2021 Accepting new patients
Emergeortho PA Rheumatology CurrentSince Apr 1, 2021 Accepting new patients
Wilmington ASC LLC CurrentSince Jul 5, 2022 Accepting new patients
Wilmington Health PLLC CurrentSince Jul 5, 2022 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.