KANCHANA NILUPUL HERATH MD
NPI 1093058877
Internal Medicine - Rheumatology in Philadelphia, PA

Q: What is Kanchana Herath's NPI number?

The NPI number for Kanchana Herath is 1093058877. It was assigned to this individual provider in the NPPES registry on March 31, 2013.

Q: What is Kanchana Herath's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Kanchana Herath was last updated on September 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 31, 2013PECOS EnrolledAccepts Medicare Assignment

1261 DIVISION HIGHWAY, STE 2, PHILADELPHIA, PA 17522(717) 299-1301(717) 299-2214 Get Directions Write a Review

NPPES record last updated: September 24, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kanchana Nilupul Herath Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANCHANA NILUPUL HERATH MD (NPI 1093058877) is an individual rheumatology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD465251) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with Upmc Lititz, and is a graduate of Pennsylvania State University College Of Medicine (2013).

NPPES Registry Identity

NPI1093058877

Entity TypeIndividualFemale

Primary Taxonomy207RR0500X

Provider Legal NameKANCHANA NILUPUL HERATHCredential: MD

Location Address1261 DIVISION HIGHWAY, STE 2Philadelphia, PA 17522-8822

Mailing Address1261 Division Highway, Ste 2Philadelphia, PA 17522-8822 · (717) 299-1301 · Fax (717) 299-2214

Phone(717) 299-1301

Fax(717) 299-2214

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 2013

Enumeration DateMarch 31, 2013

Last NPPES UpdateSeptember 24, 2018

✔ NPI 1093058877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in PA · MD465251

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

1261 DIVISION HIGHWAY, Philadelphia, PA 17522

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kanchana Nilupul Herath Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173842572

PECOS Enrollment IDI20181015002521

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, romosozumab-aqqg, 1 mg J3111

Romosozumab-aqqg is a medication given by injection to treat osteoporosis in patients at high risk for fractures. It works by increasing bone mass and strength, reducing the risk of fractures.

23,730 services21 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

7,200 services73 patients

Dxa bone density measurement of hip, pelvis, spine 77080

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

619 services619 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

474 services289 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

239 services95 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

96 services78 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

91 services89 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

60 services60 patients

Dxa bone density measurement of forearm, finger, hand, or foot 77081

A DXA bone density measurement of the forearm, finger, hand, or foot is a non-invasive procedure that uses X-rays to measure the amount of calcium and other minerals in your bones. This test helps to assess the strength of your bones and your risk of fractures.

51 services51 patients

Red blood cell sedimentation rate, to detect inflammation, automated 85652

The Red Blood Cell Sedimentation Rate is a test that helps detect inflammation in the body. It's automated, meaning a machine does the work. This test measures how fast red blood cells settle at the bottom of a tube in an hour. A faster rate may indicate inflammation.

51 services42 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

45 services35 patients

Analysis of substance using immunoassay technique, multiple step method 83516

This procedure involves the use of an immunoassay, a highly sensitive technique, to detect and measure substances in your body. It involves multiple steps and is commonly used in diagnosing and monitoring various health conditions.

30 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

27 services22 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

26 services25 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

22 services22 patients

Measurement of antibody for rheumatoid arthritis assessment 86200

This procedure measures the level of certain antibodies in your blood. These antibodies can be higher in people with rheumatoid arthritis, a condition causing joint inflammation. The test helps in diagnosing or monitoring the disease.

17 services17 patients

Rheumatoid factor level 86431

The Rheumatoid Factor Level test is a blood test that helps detect the presence of Rheumatoid Factor (RF), a protein produced by your immune system. High RF levels often indicate autoimmune diseases like rheumatoid arthritis. The test involves a simple blood draw and lab analysis.

15 services15 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Upmc Lititz

Acute Care Hospitals · Lititz, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390068

Location1500 Highlands DriveLititz, PA 17543 · Lancaster County

Emergency services Birthing friendly

Lancaster General Hospital

Acute Care Hospitals · Lancaster, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390100

Location555 North Duke StreetLancaster, PA 17602 · Lancaster County

Emergency services Birthing friendly

Wellspan Ephrata Community Hospital

Acute Care Hospitals · Ephrata, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390225

Location169 Martin AvenueEphrata, PA 17522 · Lancaster County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17522 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kanchana Herath's NPI number?

The NPI number for Kanchana Herath is 1093058877. It was assigned to this individual provider in the NPPES registry on March 31, 2013.

Where is Kanchana Herath located?

Kanchana Herath practices at 1261 Division Highway Ste 2, Philadelphia, PA 17522. The listed phone number is (717) 299-1301.

What is Kanchana Herath's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Kanchana Herath enrolled in Medicare?

Yes. Kanchana Herath is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kanchana Herath accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Kanchana Herath as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kanchana Herath affiliated with any hospitals?

According to CMS data, Kanchana Herath is affiliated with Upmc Lititz, Lancaster General Hospital and Wellspan Ephrata Community Hospital.

When was this NPI record last updated?

The NPPES record for Kanchana Herath was last updated on September 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.