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SURESH KRISHNAMOORTHY MD SC
NPI 1912101163
Internal Medicine - Geriatric Medicine in Centralia, IL

Active since June 12, 2007
1054 M L KING DR, SUITE 126, CENTRALIA, IL 62801(618) 533-5500(618) 533-5501 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Suresh Krishnamoorthy Md Sc NPPES

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

SURESH KRISHNAMOORTHY MD SC (NPI 1912101163) is a healthcare organization registered as a geriatric medicine in Centralia, Illinois and active in the NPI registry since June 2007. The organization lists Suresh Krishnamoorthy, Physician, as its authorized official.

NPPES Registry Identity

NPI1912101163
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameSURESH KRISHNAMOORTHY MD SC
Location Address1054 M L KING DR, SUITE 126Centralia, IL 62801-3000
Mailing Address1054 M L King Dr, Suite 126Centralia, IL 62801-3000 · (618) 533-5500 · Fax (618) 533-5501
Phone(618) 533-5500
Fax(618) 533-5501
Organization SubpartNo
Authorized OfficialSuresh KrishnamoorthyPhysician · (618) 533-5500
Enumeration DateJune 12, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1912101163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
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.
1054 M L KING DR, Centralia, IL 62801
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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)

Suresh Krishnamoorthy Md Sc 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 Suresh Krishnamoorthy MD Sc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Suresh Krishnamoorthy, M.D.
Internal Medicine
NPI 1760440580
1054 M L KING DR SUITE 126
Centralia, IL 62801
(618) 533-5500
✔ PECOS✔ Accepts Medicare30 mi

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 Suresh Krishnamoorthy MD Sc's NPI number?

The NPI number for Suresh Krishnamoorthy MD Sc is 1912101163. It was assigned to this organization in the NPPES registry on June 12, 2007.

Where is Suresh Krishnamoorthy MD Sc located?

Suresh Krishnamoorthy MD Sc is located at 1054 M L King Dr Suite 126, Centralia, IL 62801. The listed phone number is (618) 533-5500.

What is Suresh Krishnamoorthy MD Sc's specialty?

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

Is Suresh Krishnamoorthy MD Sc enrolled in Medicare?

Yes. Suresh Krishnamoorthy MD Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Suresh Krishnamoorthy MD Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Suresh Krishnamoorthy MD Sc. 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 Suresh Krishnamoorthy MD Sc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.