Kolala R Sridhar, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

023184 Issued in CT

Practice address

Berkshire Medical Center
725 North Street
Pittsfield, MA 01201

Phone

(413) 447-2000

NPI assigned

Oct 31, 2005

Last updated

Jul 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Kolala Ramakrishnasastry Sridhar Other name

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939
  Medicare reassignment NPD
• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625
  Medicare reassignment NPD
• United Community and Family Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norwich, CT
  • NPI 1467482539
  Medicare reassignment NPD
• Fairview Hospital

  dba East Mountain Medical

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD
• Eastern Connecticut Endoscopy Center LLC

  • Endoscopy Clinic/Center
  • Norwich, CT
  • NPI 1609864883
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1043201924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BERKSHIRE MEDICAL CENTER",
            "address_2": "725 NORTH STREET",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "01201",
            "telephone_number": "413-417-2000",
            "fax_number": "860-886-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BERKSHIRE MEDICAL CENTER",
            "address_2": "725 NORTH STREET",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "01201",
            "telephone_number": "413-447-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2139 Silas Deane Hwy",
            "address_purpose": "LOCATION",
            "city": "Rocky Hill",
            "state": "CT",
            "postal_code": "060672336",
            "country_code": "US",
            "telephone_number": "860-257-4131",
            "fax_number": "860-257-4519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-2846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016053094",
            "country_code": "US",
            "telephone_number": "508-856-8350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-2846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRIDHAR",
        "first_name": "KOLALA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2024-07-08",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "290596",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "023184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS CT",
            "identifier": "010023184CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2543540",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "NLS073",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET NE",
            "identifier": "030206",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4383009",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "611709",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOLALA",
            "last_name": "SRIDHAR",
            "middle_name": "RAMAKRISHNASASTRY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Margaret Springer
• Springfield Therapy LLC
• Jakleen Rose Squires
• SRC Pittsfield Op, LLC (Wingate Residences at Melbourne Place)
• SRC Pittsfield, LLC
• Sundeep Srikakulam, M.D.
• Seema Srinivasa Raju, MD
• Jeffrey L St John, M.D.
• Michael A. Stamm, MD
• Janet G Stanton, NP

• Gastroenterology Physician in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.