DR. TILAK C GOONERATNE (NPI# 1265400329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265400329 |
| Entity Type | Individual |
| Full Name | DR. TILAK C GOONERATNE |
| Credential | MD |
| Practice Address |
345 N Main St Ste 248 West Hartford CT 06117 |
| Practice Telephone | 8602318453 |
| Practice Fax Number | 8605234061 |
| Mailing Telephone | 8602318453 |
| Mailing Fax Number | 8605234061 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
023723 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CONNECTICARE | 021749 | 01 |
| CT | ANTHEM BCBS | 010023723CT02 | 01 |
| Street Address |
345 N MAIN ST STE 248 |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710987789 | Moshe Laub | Chiropractor | 345 N Main St, Suite 322, West Hartford, CT 06117-2515 | 2005-07-29 |
| 1699290312 | Amanda Zapka Silverman | Nurse Practitioner | 345 N Main St, West Hartford, CT 06117-2515 | 2017-08-03 |
| 1003274556 | Erin Hannan | Nurse Practitioner | 345 N Main St, Suite 248, West Hartford, CT 06117-2515 | 2016-01-28 |
| 1073981841 | Kelly Ann Riggieri | Nurse Practitioner | 345 N Main St, Suite 245, West Hartford, CT 06117-2515 | 2015-09-09 |
| 1679989792 | Konstantia E Papapateras | Dietitian, Registered | 345 N Main St, West Hartford, CT 06117-2515 | 2014-07-09 |
| 1205249604 | Gina Payne | Marriage & Family Therapist | 345 N Main St, Suite 306, West Hartford, CT 06117-2515 | 2014-06-04 |
| 1174951636 | Eliane Provencher | Nutritionist | 345 N Main St, Neiha, West Hartford, CT 06117-2515 | 2013-10-21 |
| 1447512017 | Rachel Billstrom Nelson | Obstetrics & Gynecology | 345 N Main St, Suite 201, West Hartford, CT 06117-2515 | 2012-06-11 |
| 1992073928 | The Next Right Thing | Counselor | 345 N Main St, Suite 306, West Hartford, CT 06117-2515 | 2011-12-05 |
| 1083992481 | Trinh Tu Tran | Physician Assistant | 345 N Main St, Suite 200, West Hartford, CT 06117-2515 | 2011-08-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154817237 | Mmp Therapy and Consulting | Community/Behavioral Health | 2475 Albany Avenue, West Hartford, CT 06117 | 2018-07-02 |
| 1669856555 | Noah Joseph Bluestone | Psychologist | 68 Soutth Main St, Suite 202, West Hartford, CT 06117 | 2015-07-10 |
| 1487040747 | Nancy Cabelus | Registered Nurse | 1678 Asylum Ave. Room 317, University of St. Joseph, West Hartford, CT 06117 | 2015-04-13 |
| 1124384276 | Louis Brown | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 164 Orchard Rd, West Hartford, CT 06117 | 2012-04-03 |
| 1720282882 | Ruth Kahn | Psychologist | 54 Mountain Brook Road, West Hartford, CT 06117 | 2007-06-13 |
| 1437370426 | Dana Orthodontics PC | Dentist | 2446 Albany Avenue, West Hartford, CT 06117 | 2007-05-01 |
| 1972723146 | Michelle Payson | Occupational Therapist | One Abrahms Boulevard, West Hartford, CT 06117 | 2007-04-27 |
| 1457579583 | Kathy A Mccloskey | Psychologist | 200 Bloomfield Avenue, University of Hartford, West Hartford, CT 06117 | 2007-04-23 |
| 1427181585 | Nancy L White | Naturopath | 10 Crossroads Plaza, West Hartford, CT 06117 | 2007-03-14 |
| 1689743452 | August C Olivar | Obstetrics & Gynecology | 2437 Albany Avenue, Suite 202, West Hartford, CT 06117 | 2006-11-07 |
| Find all providers in zip 06117 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942319157 | Margaret M O'neill | Pediatrics | 970 Farmington Ave Ste 201, West Hartford, CT 06107-2134 | 2006-08-30 |
| 1154399202 | Allyson N Duffy | Pediatrics | 345 North Main St, Ste 248, West Hartford, CT 06117 | 2006-03-14 |
| 1396716353 | Della M Corcoran | Pediatrics | 970 Farmington Ave, Ste 201, West Hartford, CT 06107 | 2006-01-30 |
| 1760453724 | Leo Joseph Distefano IIi | Pediatrics | 970 Farmington Avenue, Suite 201, West Hartford, CT 06107 | 2006-01-30 |
| 1952581928 | Pedicorp, PC | Pediatrics | 345 N Main St, Suite 248, West Hartford, CT 06117-2515 | 2007-11-07 |
| 1710954607 | Parvin Fadakar | Pediatrics | 345 North Main St, Ste 248, West Hartford, CT 06117 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246306 | Pediatric Health Associates of Coneecticut, LLC | Pediatrics | 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 | 2019-07-03 |
| 1073943668 | Pediatric Walk In Care LLC | Pediatrics | 141 B Hazard Avenue, Enfield, CT 06082-5412 | 2013-11-18 |
| 1225319445 | Enfield Pediatric Associates,p.c. | Pediatrics | 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 | 2011-09-01 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1326166125 | Mary A. Simon | Pediatrics | 7 Melrose Dr, Farmington, CT 06032-0893 | 2007-03-27 |
| 1376678516 | Sydney Zane Spiesel | Pediatrics | 8 Lunar Dr, Woodbridge, CT 06525-2352 | 2007-02-21 |
| 1649314279 | Charles Ray Jones | Pediatrics | 111 Park St Ste F, New Haven, CT 06511-5412 | 2007-02-16 |
| 1427110469 | Radhika Malhotra | Pediatrics | 100 Bank St, Suite 307, Seymour, CT 06483-2806 | 2006-12-15 |
| 1386704682 | Andrews Adu Adade | Pediatrics | 18 Hillandale Ave, Stamford, CT 06902-2808 | 2006-12-11 |
| 1982706032 | John Gerald Pitegoff | Pediatrics | 1225 Silver St, Middletown, CT 06457-3920 | 2006-09-01 |
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| City | WEST HARTFORD |
| Zip Code | 06117 |
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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.