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

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

State licenses

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 and National Provider Directory roles.

• PMR Virginia Holding, LLC

  • 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.