1. Home
  2. Directory
  3. New York
  4. Rochester
  5. Internal Medicine
  6. NPI Profile

DR. SHRUTI DATTA M.D.
NPI 1366643090
Internal Medicine - Geriatric Medicine in Rochester, NY

Active since May 30, 2007PECOS Enrolled
1415 PORTLAND AVE, ROCHESTER, NY 14621(585) 922-0393(585) 922-0395 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Shruti Datta M.d. NPPES

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

DR. SHRUTI DATTA M.D. (NPI 1366643090) is an individual geriatric medicine provider in Rochester, New York, licensed in New York (255593) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366643090
Entity TypeIndividualFemale
Primary Taxonomy207RG0300X
Provider Legal NameDR. SHRUTI DATTACredential: M.D.
Location Address1415 PORTLAND AVERochester, NY 14621-3038
Mailing Address1415 Portland AveRochester, NY 14621-3038 · (585) 922-0393 · Fax (585) 922-0395
Phone(585) 922-0393
Fax(585) 922-0395
Sole ProprietorNo
Enumeration DateMay 30, 2007
Last NPPES UpdateDecember 15, 2021
✔ NPI 1366643090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
Licenses✔ Licensed in NY · 255593✔ Licensed in MN · 55592
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedInternal MedicineTaxonomy 207R00000X · License 255593 (NY)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 106218 (MN)
1415 PORTLAND AVE, Rochester, NY 14621
Open in Google Maps ↗

Other Identifiers 3

MedicaidENROLLEDIA
Medicaid03299878NY
MedicaidENROLLEDMN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shruti Datta M.d. 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 Reassignments

2

Medicare enrollment records show Shruti Datta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
2,300 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000
Contra Costa County
2,329 mi
Adult Mental Health
2311 LOVERIDGE RD, 1ST AND 2ND FLOORS
Pittsburg, CA 94565
  • Reassigned Medicare billing, California enrollment
  • 530 clinicians in this Medicare group
NPI 1073691598 (925) 431-2600

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 14621 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
$166.88 typical visit price
range $54.87 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 20

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

DR. LAURA J VON DOENHOFF M.D.
Internal Medicine (Cardiovascular Disease)
1415 PORTLAND AVE, SUITE 555
ROCHESTER, NY 14621
Monroe County (585) 336-5050
MS. SARA ELIZABETH DOE P.A.
Physician Assistant (Surgical)
1415 PORTLAND AVE, DEPARTMENT OF SURGERY
ROCHESTER, NY 14621
Monroe County (585) 922-4715
DR. ABDALLAH YOUSSEF BITAR MD/PHD
Internal Medicine (Cardiovascular Disease)
1415 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 442-5320
DENETRA MORRIS
Social Worker (Clinical)
1415 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-3653
DR. MEREDITH J CRICCO M.D.
Internal Medicine (Geriatric Medicine)
1415 PORTLAND AVE, GERIATRIC CONSULTATIVE SERVICES
ROCHESTER, NY 14621
Monroe County (585) 922-0390
NORTHSIDE ECHOCARDIOGRAPHY, PC
Specialist
1415 PORTLAND AVE, SUITE 555
ROCHESTER, NY 14621
Monroe County (585) 336-5050
LARISSA CHAPKOVICH R.D.
Dietitian, Registered
1415 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-4200
CHRISTOPHER JESSE RICHARDSON D.O.
Surgery
1415 PORTLAND AVE, SUITE 245
ROCHESTER, NY 14621
Monroe County (585) 922-4891

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 Shruti Datta's NPI number?

The NPI number for Shruti Datta is 1366643090. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Where is Shruti Datta located?

Shruti Datta practices at 1415 Portland Ave, Rochester, NY 14621. The listed phone number is (585) 922-0393.

What is Shruti Datta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Shruti Datta enrolled in Medicare?

Yes. Shruti Datta is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shruti Datta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shruti Datta reassigns Medicare benefits to 2 organizations: Permanente Medical Group Inc (Stockton, CA) and Contra Costa County (Pittsburg, CA). Each 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 Shruti Datta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shruti Datta was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.