NPIMap

Individual provider Active NPI

Dileema Kalansuriya

  • Internal Medicine Physician
  • Southbury, CT
National Provider Identifier
1972785608
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1563394K73 Issued in CT
Practice address
22 Old Waterbury Rd
Suite 108
Southbury, CT 06488-3848
Phone
(203) 262-4200
Fax
(203) 264-1534
NPI assigned
Dec 5, 2007
Last updated
Aug 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1563394K73 CT Primary

Addresses

Primary practice location

22 Old Waterbury Rd
Suite 108
Southbury, CT 06488-3848

Mailing address

22 Old Waterbury Rd
Suite 108
Southbury, CT 06488-3848
Phone (203) 262-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110115000035 CT Practitioner - Internal Medicine 9335338789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

22 Old Waterbury Rd
Southbury, CT 06488-3848
Phone (203) 262-4200

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1563394K73CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Sep 22, 2010 Accepting new patients
Danbury Hospital Current Accepting new patients
Danbury Hospital CurrentSince Feb 2, 2011 Accepting new patients
Southbury Medical Associates, LLP Internal Medicine Past Accepting new patients

Locations

20 Germantown Rd
Danbury, CT 06810
Phone (203) 739-4820

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

22 Old Waterbury Rd
Southbury, CT 06488
Phone (203) 262-4200

22 Old Waterbury Rd
Ste 108
Southbury, CT 06488
Phone (203) 262-4200

Organizations & group practices 4

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 9

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1972785608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLD WATERBURY RD",
            "address_2": "SUITE 108",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883848",
            "telephone_number": "203-262-4200",
            "fax_number": "203-264-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD WATERBURY RD",
            "address_2": "SUITE 108",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883848",
            "telephone_number": "203-262-4200",
            "fax_number": "203-264-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANSURIYA",
        "first_name": "DILEEMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "1563394K73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.