SHRUTHI SAMBAMOORTHY MD
NPI 1174936587
Internal Medicine in Richmond, VA

Q: What is Shruthi Sambamoorthy's NPI number?

The NPI number for Shruthi Sambamoorthy is 1174936587. It was assigned to this individual provider in the NPPES registry on June 4, 2014.

Q: What is Shruthi Sambamoorthy's specialty?

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

Active since June 04, 2014PECOS Enrolled

1712 E BROAD ST, RICHMOND, VA 23223(804) 344-9848 Get Directions Write a Review

NPPES record last updated: March 25, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 25, 2020, Aug 2, 2017 (2 updates tracked since 2017).

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About Shruthi Sambamoorthy Md NPPES

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

SHRUTHI SAMBAMOORTHY MD (NPI 1174936587) is an individual internal medicine provider in Richmond, Virginia, licensed in Virginia (0101262213) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Buffalo.

NPPES Registry Identity

NPI1174936587

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameSHRUTHI SAMBAMOORTHYCredential: MD

Location Address1712 E BROAD STRichmond, VA 23223-6930

Mailing Address1395 Nw 167th StMiami Gardens, FL 33169-5710 · (804) 344-9848 · Fax (804) 344-5644

Phone(804) 344-9848

Sole ProprietorYes

Enumeration DateJune 4, 2014

Last NPPES UpdateMarch 25, 20202 updates tracked since enumeration

NPPES CertifiedMarch 25, 2020

✔ NPI 1174936587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in VA · 0101262213

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1712 E BROAD ST, Richmond, VA 23223

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Secondary Practice Location 1

Location 1462 Grider StreetBuffalo, NY 14215 · Phone (716) 898-5210 · Fax (716) 898-3279

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shruthi Sambamoorthy Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shruthi Sambamoorthy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pmr Virginia Holding, LLC

816 mi

Specialist

1395 NW 167TH ST
Miami Gardens, FL 33169

Reassigned Medicare billing, Virginia enrollment
100 clinicians in this Medicare group

NPI 1083167001 (305) 628-6117

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$129.04 typical visit price

range $56.19 – $170.30

Typical copayment $32.26 (range $14.04 – $42.57)

Most-billed visit code 99204

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK STEVEN GOTTLIEB D.O.

Family Medicine