MEDICARE: DR. SISIRA RANASINGHE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	01026434A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	220029374	OTHER	IN	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4896	OTHER	IN	PHYSICIANS HEALTH PLAN
3	000000083909	OTHER	IN	ANTHEM BLUE CROSS
4	1111054	OTHER	IN	CIGNA INSURANCE
6	3647	OTHER	IN	PARTNERS HEALTH PLAN

General Provider Information

NPI Number	:	1245233881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SISIRA RANASINGHE M.D.

Provider Business Mailing Address
First Line	:	228 E COLLINS RD STE D
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-5394
Country	:	US
Telephone Number	:	260-471-7675
Fax Number	:	260-471-0701

Provider Business Practice Location Address
First Line	:	228D E COLLINS RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-5304
Country	:	US
Telephone Number	:	260-471-7675
Fax Number	:	260-471-0701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/10/2008

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