Shruthi Sambamoorthy, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101262213 Issued in VA

Practice address

1712 E Broad St
Richmond, VA 23223-6930

Phone

(804) 344-9848

NPI assigned

Jun 4, 2014

Last updated

Mar 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• PMR Virginia Holding, LLC

  dba Jencare Senior Medical Centers of Virginia

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001

  Single Specialty, VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1174936587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "804-344-9848",
            "fax_number": "804-344-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236930",
            "telephone_number": "804-344-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Grider Street",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "14215",
            "country_code": "US",
            "telephone_number": "716-898-5210",
            "fax_number": "716-898-3279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMBAMOORTHY",
        "first_name": "SHRUTHI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101262213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam E English II DDS LLC
• Sam's Club Optical
• Sami Samaan, MD
• Usama Samaan, MD
• Mohammed Rasool Samarah, DDS
• Yuzuru Sambommatsu
• Attique Samdani, M.D.
• Rafia Samdani, MD
• Michelle Sames, CRNA
• Julie Anne Samitt, LCSW

• Internal Medicine Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.