Organization Active NPI

Shriram Sirsikar LLC

  • Internal Medicine Physician
  • Johnstown, PA
National Provider Identifier
1831560036
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SHRIRAM SIRSIKAR LLC
Practice address
321 Main St
Suite 3G
Johnstown, PA 15901-1632
Phone
(814) 535-7576
Fax
(814) 536-1369
NPI assigned
Oct 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Christina Larosse
Title
Manager
Phone
(814) 535-7576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X PA Primary

Addresses

Primary practice location

321 Main St
Suite 3G
Johnstown, PA 15901-1632

Mailing address

105 Rosewood Rd
Ebensburg, PA 15931-4352
Phone (814) 254-6673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151217000351 PA Part B Supplier - Clinic/Group Practice 0547561573 Receives reassigned benefits from 1 practitioner
Practice locations: Johnstown, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1831560036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ROSEWOOD RD",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314352",
            "telephone_number": "814-254-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST",
            "address_2": "SUITE 3G",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011632",
            "telephone_number": "814-535-7576",
            "fax_number": "814-536-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRIRAM SIRSIKAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "LAROSSE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "814-535-7576"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.