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Isuru Sampath Jayaratna

Urology

Allopathic & Osteopathic Physicians

5 E 98th St Fl 6, New York, NY 10029-6501

PECOS Enrollment

This provider is enrolled in PECOS as ISURU JAYARATNA.

Based on the most recent information from CMS, provider Isuru Sampath Jayaratna is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 7:46 AM.

Profile Details

Provider ID
1578884128
Provider Type
Individual
Full Name
Jayaratna, Isuru Sampath
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/17/2010
Last Updated
3/17/2018

Contact Information

Practice Location

5 E 98th St Fl 6, New York, NY 10029-6501

(212) 659-5559

Unlisted Fax

Mailing Location

5 E 98th St Fl 6, New York, NY 10029-6501

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208800000X Primary	Description Urology Allopathic & Osteopathic Physicians	License 286840 New York
Code 208800000X	Description Urology Allopathic & Osteopathic Physicians	License Q3387 Texas
Code 208800000X	Description Urology Allopathic & Osteopathic Physicians	License A112522 California

Provider Identifiers

ID	Description	Issuer
ID 349374401 (MDACC)	Description Medicaid	Issuer Unlisted Texas

Isuru Sampath Jayaratna

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

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License

Code

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Provider Identifiers

ID

Description

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ID

Description

Issuer

Zaytoun, Osama Motawa

Ahlawat, Rajesh Kumar

Mehrazin, Reza

Dovey, Zach Seth

Faculty Practice Associates Mount Sinai School Of Medicine

Nymhc Fpp Urology

De Almeida Luz, Murilo

David B Samadi Md Pc

Amend, Gregory

Icahn School Of Medicine At Mount Sinai