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SUDHA DIRISANALA
NPI 1922703586
Student in an Organized Health Care Education/Training Program in Gainesville, GA

Active since April 03, 2023PECOS EnrolledAccepts Medicare Assignment
1439 JESSE JEWELL STE. 301, GAINESVILLE, GA 30501(770) 219-0023 Get Directions Write a Review

NPPES record last updated: July 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 12, 2023, Apr 3, 2023 (2 updates tracked since 2023).

About Sudha Dirisanala NPPES

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

SUDHA DIRISANALA (NPI 1922703586) is an individual student in an organized health care education/training program in Gainesville, Georgia and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1922703586
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameSUDHA DIRISANALA
Location Address1439 JESSE JEWELL STE. 301Gainesville, GA 30501
Mailing Address743 Spring Street, Suite 710Gainesville, GA 30501 · (770) 219-8730
Phone(770) 219-0023
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 3, 2023
Last NPPES UpdateJuly 12, 20232 updates tracked since enumeration
NPPES CertifiedJuly 12, 2023
✔ NPI 1922703586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1439 JESSE JEWELL STE. 301, Gainesville, GA 30501
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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

Sudha Dirisanala 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 ID2365803111
PECOS Enrollment IDI20260702003940
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.

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 Sudha Dirisanala's NPI number?

The NPI number for Sudha Dirisanala is 1922703586. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Where is Sudha Dirisanala located?

Sudha Dirisanala practices at 1439 Jesse Jewell Ste. 301, Gainesville, GA 30501. The listed phone number is (770) 219-0023.

What is Sudha Dirisanala's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Sudha Dirisanala enrolled in Medicare?

Yes. Sudha Dirisanala 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.

When was this NPI record last updated?

The NPPES record for Sudha Dirisanala was last updated on July 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.