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NALAKA S GOONERATNE MD
NPI 1235170663
Internal Medicine - Sleep Medicine in Philadelphia, PA

Active since June 09, 2006PECOS EnrolledAccepts Medicare Assignment
85.48/100
CMS Quality Rating
51 N 39TH ST, PHILADELPHIA, PA 19104(215) 662-2749(215) 243-4624 Get Directions Write a Review

NPPES record last updated: September 30, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nalaka S Gooneratne Md NPPES

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

NALAKA S GOONERATNE MD (NPI 1235170663) is an individual sleep medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD057418L) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Northwestern University Feinberg Medical School (1993).

NPPES Registry Identity

NPI1235170663
Entity TypeIndividualMale
Primary Taxonomy207RS0012X
Provider Legal NameNALAKA S GOONERATNECredential: MD
Location Address51 N 39TH STPhiladelphia, PA 19104-2640
Mailing Address51 N 39th StPhiladelphia, PA 19104-2640 · (215) 662-2749 · Fax (215) 243-4624
Phone(215) 662-2749
Fax(215) 243-4624
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1993
Enumeration DateJune 9, 2006
Last NPPES UpdateSeptember 30, 2019
✔ NPI 1235170663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0012X
License✔ Licensed in PA · MD057418L
Definition
An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
51 N 39TH ST, Philadelphia, PA 19104
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Other Identifiers 1

Medicaid0018457530001PA

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

Nalaka S Gooneratne 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 ID8729068044
PECOS Enrollment IDI20040726000494
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

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.

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.
58 services35 patients

Hospital Affiliations CMS Care Compare

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.6
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
6 suppliers36 claims36 services$31.99 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers25 claims25 services$76.86 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
6 suppliers24 claims66 services$30.15 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers29 claims161 services$14.57 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
7 suppliers41 claims41 services$46.60 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
9 suppliers38 claims38 services$15.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT BURKE M.D.
Internal Medicine
51 N 39TH ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-9436
JOSEPH FRANCIS HARRYHILL MD
Urology
51 N 39TH ST, MOB SUITE 300
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-8699
NIELS DOUGLAS MARTIN MD
Surgery (Trauma Surgery)
51 N 39TH ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 349-8310
DESIREE E KOTARBA CRNA
Registered Nurse
51 N 39TH ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-8000
DR. SONYA LEE MD
Obstetrics & Gynecology (Gynecology)
51 N 39TH ST, MOB 340
PHILA, PA 19104
Philadelphia County (215) 662-9775
GARY J VIGILANTE MD
Internal Medicine (Cardiovascular Disease)
51 N 39TH ST, PHI BLDG STE 2C PENN PRESBYTERIAN MEDICAL CENTER
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-9010
ANITA C LEE MD
Internal Medicine
51 N 39TH ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-9436
GIRIDHAR MALLYA MD
Family Medicine
51 N 39TH ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-8777

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 Nalaka Gooneratne's NPI number?

The NPI number for Nalaka Gooneratne is 1235170663. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Nalaka Gooneratne located?

Nalaka Gooneratne practices at 51 N 39th St, Philadelphia, PA 19104. The listed phone number is (215) 662-2749.

What is Nalaka Gooneratne's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Is Nalaka Gooneratne enrolled in Medicare?

Yes. Nalaka Gooneratne 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 Nalaka Gooneratne accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Nalaka Gooneratne 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 Nalaka Gooneratne affiliated with any hospitals?

According to CMS data, Nalaka Gooneratne is affiliated with Hospital Of Univ Of Pennsylvania.

When was this NPI record last updated?

The NPPES record for Nalaka Gooneratne was last updated on September 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.