ASITHA DINETH LIBBEY JAYAWARDENA (NPI# 1689093460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689093460 |
| Entity Type | Individual |
| Full Name | ASITHA DINETH LIBBEY JAYAWARDENA |
| Credential | MD, MPH |
| Practice Address |
2525 Chicago Ave Minneapolis MN 55404-4518 |
| Practice Telephone | 6128741292 |
| Practice Fax Number | 6128136889 |
| Mailing Telephone | 6128741292 |
| Mailing Fax Number | 6128136889 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2020-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YP0228X |
Otolaryngology Specialization: Pediatric Otolaryngology |
NA | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7209 Medical Center East South Tower, 1215 21st Avenue South, Nashville, TN 372328605 | 6153436972 |
| Street Address |
2525 CHICAGO AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-4518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083611511 | William Francis Pomputius IIi | Pediatrics | 2525 Chicago Ave, Mailstop 17-318, Minneapolis, MN 55404-4518 | 2005-06-30 |
| 1174124259 | Anna-wesleigh Riggs Akins | Registered Nurse | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-11-04 |
| 1255930202 | Gershom Aaron Tam | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-10-21 |
| 1275140477 | Jessica Bloom | Nurse Anesthetist, Certified Registered | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-30 |
| 1538775762 | Ahmed Elazab | Pharmacist | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-22 |
| 1275149957 | Jennifer Siegmann | Nurse Anesthetist, Certified Registered | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-18 |
| 1710592530 | Mildred Denise Kiawoin | Registered Nurse | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-09 |
| 1992310700 | Coltyn Tyler Johnson | Nurse Anesthetist, Certified Registered | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-09 |
| 1619581394 | Children's Health Care | Ambulance | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-09-01 |
| 1447861067 | Charlotte Minnema | Nurse Practitioner | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2020-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 207YP0228X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Pediatric Otolaryngology |
| A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264435 | Timothy Alan Lander | Otolaryngology | 910 E 26th St, Ste 323, Minneapolis, MN 55404-4549 | 2005-06-08 |
| 1295026540 | Courtney Anne Hill | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2011-04-20 |
| 1669556668 | Pediatric Ent Associates | Otolaryngology | 910 E 26th St, Suite 323, Minneapolis, MN 55404-4526 | 2006-10-25 |
| 1003818824 | Richard M. Levinson | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780942243 | Angela Vong | Otolaryngology | 2080 Woodwinds Dr Ste 240, Woodbury, MN 55125 | 2012-05-02 |
| 1013953371 | Richard G Karlen | Otolaryngology | 2080 Woodwinds Drive, #240, Woodbury, MN 55125 | 2006-06-22 |
| City | MINNEAPOLIS |
| Zip Code | 55404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.