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K.S. BOODRAM, MD PLLC
NPI 1093926552
Internal Medicine in Prince George, VA

Active since May 25, 2007
4300 CROSSINGS BLVD STE 101, PRINCE GEORGE, VA 23875(804) 526-7900(804) 526-7195 Get Directions Write a Review

NPPES record last updated: March 10, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 10, 2024, Aug 22, 2022, Apr 26, 2022 (3 updates tracked since 2022).

About K.s. Boodram, Md Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

K.S. BOODRAM, MD PLLC (NPI 1093926552) is a healthcare organization registered as an internal medicine in Prince George, Virginia and active in the NPI registry since May 2007. The organization maintains a secondary practice location in Petersburg and lists Sharon Boodram, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1093926552
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameKADARNATH S BOODRAM MD LLC
Location Address4300 CROSSINGS BLVD STE 101Prince George, VA 23875-1452
Mailing Address4300 Crossings Blvd Ste 101Prince George, VA 23875-1452 · (804) 526-7900 · Fax (804) 526-7195
Phone(804) 526-7900
Fax(804) 526-7195
Organization SubpartNo
Authorized OfficialSharon BoodramPractice Manager · (804) 526-7900
Enumeration DateMay 25, 2007
Last NPPES UpdateMarch 10, 20243 updates tracked since enumeration
NPPES CertifiedMarch 10, 2024
✔ NPI 1093926552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0101229800
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4300 CROSSINGS BLVD STE 101, Prince George, VA 23875
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Other Names 1

Doing Business AsK.s. Boodram, Md Pllc

Secondary Practice Location 1

Location 1601 Old Wagner Road, Suite 103Petersburg, VA 23805-9313 · Phone (804) 526-7900 · Fax (804) 526-7195

Other Identifiers 11

Other0408689VA · United Healthcare
Other7604973VA · Ghi
Medicaid010124701VA
Other8130003VI · Mamsi
Other0504963VI · Cigna
Other254668VI · Souothern Health
Other3689195VA · Aetna Hmo
Other54180VI · Carenet
Other172714VA · Anthem
Other7404178VA · Aetna Ppo
Other94167VA · Sentara Optima

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

K.s. Boodram, Md Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to K.S. Boodram, MD PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kadarnath Boodram, MD
Internal Medicine
NPI 1679546923
4300 CROSSINGS BLVD STE 101
Prince George, VA 23875
(804) 526-7900
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kadarnath S Boodram MD LLC's NPI number?

The NPI number for Kadarnath S Boodram MD LLC is 1093926552. It was assigned to this organization in the NPPES registry on May 25, 2007. The provider is doing business as K.S. Boodram, MD PLLC.

Where is Kadarnath S Boodram MD LLC located?

Kadarnath S Boodram MD LLC is located at 4300 Crossings Blvd Ste 101, Prince George, VA 23875. The listed phone number is (804) 526-7900.

What is Kadarnath S Boodram MD LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kadarnath S Boodram MD LLC enrolled in Medicare?

Yes. Kadarnath S Boodram MD LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kadarnath S Boodram MD LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Kadarnath S Boodram MD LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kadarnath S Boodram MD LLC was last updated on March 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.