Samantha Sharmini Dewundara, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101258106 Issued in VA

Practice address

241 Corporate Blvd
Suite 210
Norfolk, VA 23502-4975

Phone

(757) 622-2200

Fax

(757) 965-9493

NPI assigned

Sep 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Other names 1

• Ms. Patabendige Samantha Sharmini Dewundara Former name

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

Specialty

Ophthalmology

Education

Wayne State University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Eye Consultants IncGroup PAC ID 6608860978, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

Merit-based Incentive Payment System (MIPS)

Final score

81.39 of 100Reported as group

Quality

77.12

Promoting interoperability

100

Improvement activities

40

Cost

60.85

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: samantha.dewundara.p1@direct.vec.nextgenshare.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.

• Virginia Eye Consultants Inc

  • Ophthalmology Physician
  • Norfolk, VA
  • NPI 1992727820
  Medicare reassignment Care Compare group NPD
• South Suburban Ear, Nose & Throat Assoc Inc

  • Otolaryngology Physician
  • South Weymouth, MA
  • NPI 1568572907
  NPD (past)

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

• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1659689693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CORPORATE BLVD",
            "address_2": "SUITE 210",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024975",
            "telephone_number": "757-622-2200",
            "fax_number": "757-965-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CORPORATE BLVD",
            "address_2": "SUITE 210",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024975",
            "telephone_number": "757-622-2200",
            "fax_number": "757-965-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWUNDARA",
        "first_name": "SAMANTHA",
        "middle_name": "SHARMINI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101258106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "547397",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10152490",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01548824",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/COVENTRY",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "1659689693",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659689693",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATABENDIGE SAMANTHA",
            "last_name": "DEWUNDARA",
            "middle_name": "SHARMINI",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ophthalmology Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.