Siddharth Srikakolapu, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

92836 Issued in SC

Practice address

169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425-3150

Phone

(843) 876-5074

Fax

(843) 792-5858

NPI assigned

Oct 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1235856964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294253150",
            "telephone_number": "843-876-5074",
            "fax_number": "843-792-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294253150",
            "telephone_number": "843-876-5074",
            "fax_number": "843-792-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIKAKOLAPU",
        "first_name": "SIDDHARTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "92836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay M Squeglia, PHD
• Gregory Thomas Squires, MD
• Jerry Ewing Squires, MD
• Sri Medical LLC
• Sreesh Sridhar, MD
• Ganga L Srinivas, MD
• Niharika Srivastava, DO
• Romik Prakash Srivastava, MD
• SRP Medical LLC
• St Andrews Medical Inc

• Dermatology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.