SAMUEL MARK SHOR M.D.
NPI 1184611964
Internal Medicine in Reston, VA

Active since October 05, 2005Opted out of Medicare · through Aug 7, 2027
1860 TOWN CENTER DR, SUITE 230, RESTON, VA 20190(703) 709-1119(703) 709-7496 Get Directions Write a Review

NPPES record last updated: January 5, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Samuel Mark Shor M.d. NPPES

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

SAMUEL MARK SHOR M.D. (NPI 1184611964) is an individual internal medicine provider in Reston, Virginia, licensed in Virginia (101036333) and active in the NPI registry since October 2005. He has opted out of Medicare through August 7, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1184611964
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSAMUEL MARK SHORCredential: M.D.
Location Address1860 TOWN CENTER DR, SUITE 230Reston, VA 20190-5896
Mailing Address1860 Town Center Dr, Suite 230Reston, VA 20190-5896 · (703) 709-1119 · Fax (703) 709-7496
Fax(703) 709-7496
Sole ProprietorYes
Enumeration DateOctober 5, 2005
Last NPPES UpdateJanuary 5, 2012
NPI 1184611964 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 · 101036333
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.

1860 TOWN CENTER DR, Reston, VA 20190

Other Identifiers 5

Other745990VA · Cigna Provider Number
Other504468VA · Ncppo Provider Number
Medicare UPINC62782VA
Medicare ID-Type Unspecified438277I93VA
Medicare ID-Type UnspecifiedP00147647VA · Railroad Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Samuel Mark Shor M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 7, 2017 through August 7, 2027.

Opt-Out Effective DateAugust 7, 2017
Opt-Out In Effect ThroughAugust 7, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20190 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier11 claims11 services$16.36 avg. paid by Medicare
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg J1569
Treatment-Injections and Infusions (nononcologic) · category RI008N
1 supplier11 claims440 services$35.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

Specialist
1860 TOWN CENTER DR, SUITE 350
RESTON, VA 20190
Physical Therapist (Orthopedic)
1860 TOWN CENTER DR
RESTON, VA 20190
Internal Medicine
1860 TOWN CENTER DR, SUITE 310
RESTON, VA 20190
Physical Therapist
1860 TOWN CENTER DR, SUITE 300
RESTON, VA 20190
Physical Therapy Assistant
1860 TOWN CENTER DR, SUITE 300
RESTON, VA 20190
Registered Nurse (Registered Nurse First Assistant)
1860 TOWN CENTER DR, SUITE 300
RESTON, VA 20190
Orthopaedic Surgery (Sports Medicine)
1860 TOWN CENTER DR, SUITE 300
RESTON, VA 20190
Psychiatry & Neurology (Neurology)
1860 TOWN CENTER DR, SUITE 320
RESTON, VA 20190

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 Samuel Shor's NPI number?

The NPI number for Samuel Shor is 1184611964. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Samuel Shor located?

Samuel Shor practices at 1860 Town Center Dr Suite 230, Reston, VA 20190. The listed phone number is (703) 709-1119.

What is Samuel Shor's specialty?

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

Is Samuel Shor enrolled in Medicare?

No. Samuel Shor has opted out of Medicare through August 7, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Samuel Shor was last updated on January 5, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.