Samuel T Richbourg, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

58473 Issued in KY

Practice address

601 E Rollins St
Orlando, FL 32803-1248

Phone

(407) 303-1944

Fax

(407) 303-1746

NPI assigned

Jul 6, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Radiology Imaging at Lake Mary LLCGroup PAC ID 1254311137, 273 clinicians

Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
• Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
• Adventhealth Deland Hospital, Deland, FL, CCN 100045
• Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: srichbourg56596@adventhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Hospital Medical Group Inc

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1073785044

  KY

  Medicare reassignment Care Compare group NPD
• Florida Radiology Imaging at Lake Mary, LLC

  • Diagnostic Radiology Physician
  • Lake Mary, FL
  • NPI 1740256494
  Medicare reassignment Care Compare group NPD
• Florida Radiology Imaging at Lake Mary, LLC

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1003208620
  NPD
• Florida Radiology Imaging at Lake Mary LLC

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1003983610
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Palm Coast Parkway Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1861102345
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation
• Florida Hospital Waterman Inc

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• Memorial Health Systems Inc

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1063426823
  Care Compare affiliation
• Memorial Health Systems Inc

  • Clinical Medical Laboratory
  • Daytona Beach, FL
  • NPI 1104696178

  Hospital

  Care Compare affiliation
• Memorial Hospital-West Volusia Inc

  • General Acute Care Hospital
  • Deland, FL
  • NPI 1649367269
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1174520134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150505",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327150505",
            "telephone_number": "407-767-0433",
            "fax_number": "407-767-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-1944",
            "fax_number": "407-303-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHBOURG",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME41914",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "58473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068128800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300118096",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "47537",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Ann Richardson
• Randi Moak Richardson, DPT, SCS
• Tonika Richardson
• Delaney Jo Richason
• Solomon Rashawn Richberg III
• Robie Richemond, RN
• Bradley Richey
• Maria Richiez Medina
• Laurence Richman, DPM
• Alex Richmond

• Diagnostic Radiology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.