Individual provider Active NPI

Patalam Sriramulu Sriharsha, M.D.

  • Geriatric Psychiatry Physician
  • Hazleton, PA
National Provider Identifier
1154377562
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
MD025995E Issued in PA
Practice address
750 E Broad St
Hazleton, PA 18201-6835
Phone
(570) 455-6385
Fax
(570) 455-7064
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X MD025995E PA Primary

Addresses

Primary practice location

750 E Broad St
Hazleton, PA 18201-6835

Mailing address

750 E Broad St
Hazleton, PA 18201-6835
Phone (570) 455-6385

Other identifiers 1

IdentifierTypeStateIssuer
0008345120004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120530000166 PA Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 9234392390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Counseling Services CurrentSince Mar 24, 2012 Accepting new patients

Locations

750 E Broad St
Hazleton, PA 18201

121 S Prospect St
Nanticoke, PA 18634
Phone 5704556385 ext. 255

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154377562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016835",
            "telephone_number": "570-455-6385",
            "fax_number": "570-455-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016835",
            "telephone_number": "570-455-6385",
            "fax_number": "570-455-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIHARSHA",
        "first_name": "PATALAM",
        "middle_name": "SRIRAMULU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PA",
            "license": "MD025995E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008345120004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.