| Suresh Jayantha Desilva, MD | |
|
21332 Nautique Blvd, Apt # 204, Cornelius, NC 28031-6410 | |
| (704) 650-3789 | |
| Not Available |
| Full Name | Suresh Jayantha Desilva |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 32 Years |
| Location | 21332 Nautique Blvd, Cornelius, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356304869 | NPI | - | NPPES |
| 89107OL | Medicaid | NC | |
| 2246349F | Other | NC | MEDICARE PART B PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 00971315 (North Carolina) | Secondary |
| 207P00000X | Emergency Medicine | 13961 (Nevada) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southern Hills Hospital And Medical Center | Las vegas, NV | Hospital |
| Mountainview Hospital | Las vegas, NV | Hospital |
| Sunrise Hospital And Medical Center | Las vegas, NV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fremont Emergency Services Scherr Ltd | 4880684554 | 122 |
| Entity Name | William Bee Ririe Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487648804 PECOS PAC ID: 9335051747 Enrollment ID: O20031104000372 |
| Entity Name | South Lyon Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932160363 PECOS PAC ID: 0648178533 Enrollment ID: O20031230000357 |
| Entity Name | Fremont Emergency Services Scherr Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679550149 PECOS PAC ID: 4880684554 Enrollment ID: O20040514000465 |
| Entity Name | South Lyon Health Center Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1376917302 PECOS PAC ID: 0648178533 Enrollment ID: O20160113002811 |
| Mailing Address | Practice Location Address |
|---|---|
| Suresh Jayantha Desilva, MD 21332 Nautique Blvd, Apt # 204, Cornelius, NC 28031-6410 Ph: (704) 650-3789 | Suresh Jayantha Desilva, MD 21332 Nautique Blvd, Apt # 204, Cornelius, NC 28031-6410 Ph: (704) 650-3789 |