MEDICARE: SAMANTHA SENANAYAKA MPAS, PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1912241506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA SENANAYAKA MPAS, PA-C

Provider Business Mailing Address
First Line	:	4115 HARRISON ST
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68147-1059
Country	:	US
Telephone Number	:	402-932-0692
Fax Number	:

Provider Business Practice Location Address
First Line	:	4115 HARRISON ST
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68147-1059
Country	:	US
Telephone Number	:	402-932-0692
Fax Number	:

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

Provider Enumeration Date	:	11/20/2012
Last Update Date	:	07/17/2023

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Directions to “ SAMANTHA SENANAYAKA MPAS, PA-C” Practice Location

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