NPIMap

Individual provider Active NPI

Shivaram Cumarasamy, MD

  • Urology Physician
  • New York, NY
National Provider Identifier
1508363359
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101286959 Issued in VA
Practice address
Department of Urology 1272
1 Gustave L Place
New York, NY 10029
Phone
(609) 502-5639
NPI assigned
Apr 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101286959 VA Primary

Addresses

Primary practice location

Department of Urology 1272
1 Gustave L Place
New York, NY 10029

Mailing address

225 Clearfield Ave
Virginia Beach, VA 23462-1815

Other practice location 1

16000 Johnston Memorial Dr Ste 300
Abingdon, VA 24211-0005
Phone (276) 258-3820 ext. 81000

Other practice location 2

229 Clearfield Ave Ste 300
Virginia Beach, VA 23462-1946
Phone (757) 457-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230908000041 PA Practitioner - Urology 9133465792 Reassigns benefits to 1 organization
I20250919002574 VA Practitioner - Urology 9133465792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of Virginia, PLLCGroup PAC ID 2062681679, 74 clinicians

Practice addresses (Care Compare)

229 Clearfield Ave
Suite 300
Virginia Beach, VA 23462-1815
Phone (757) 457-5177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101286959VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jul 27, 2023 Accepting new patients
Urology of Virginia, PLLC Urology CurrentSince Dec 1, 2025 Accepting new patients
Wellmont Health System Current Accepting new patients
Temple Faculty Practice Plan Inc Urology CurrentSince Jul 27, 2023 Accepting new patients
Urology of Virginia, PLLC Urology CurrentSince Dec 1, 2025 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients

Locations

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3656

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

225 Clearfield Ave
Virginia Beach, VA 23462
Phone (757) 452-3459

Interoperability endpoints

  • Direct secure messaging: scumarasamy529887@balladhealth.medalliesdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1508363359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CLEARFIELD AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF UROLOGY 1272",
            "address_2": "1 GUSTAVE L PLACE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "609-502-5639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16000 Johnston Memorial Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242110005",
            "country_code": "US",
            "telephone_number": "276-258-3820 x81000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Clearfield Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621946",
            "country_code": "US",
            "telephone_number": "757-457-5100",
            "fax_number": "757-961-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMARASAMY",
        "first_name": "SHIVARAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-09",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101286959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.