Individual provider Active NPI

Sridhar Jatla, MD

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Kokomo, IN
National Provider Identifier
1891704565
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
01063214A Issued in IN
Practice address
2330 S Dixon Rd Ste 325
Kokomo, IN 46902-6430
Phone
(765) 455-8822
Fax
(765) 865-3935
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01063214A IN
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 01063214A IN Primary

Addresses

Primary practice location

2330 S Dixon Rd Ste 325
Kokomo, IN 46902-6430

Mailing address

6983 Hillsdale CT
Indianapolis, IN 46250-2054
Phone (317) 849-8350

Other identifiers 1

IdentifierTypeStateIssuer
200903530MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals@jwmn.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20081017000321 IN Practitioner - PsychiatryPractitioner - Sleep MedicinePractitioner - Other (Physician) 1658452974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Sleep Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Josephson-Wallack-Munshower Neurology PCGroup PAC ID 6709868870, 59 clinicians

Practice addresses (Care Compare)

12188 A N Meridian St
Suite 320
Carmel, IN 46032-4407
Phone (317) 580-0420

411 W Tipton St
Schneck Medical Center
Seymour, IN 47274-2363
Phone (812) 522-2349

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.89 of 100Reported as group
Promoting interoperability
56
Improvement activities
40
Cost
76.39

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063214AINMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Josephson-Wallack-Munshower Neurology PC CurrentSince Nov 28, 2011 Accepting new patients
Jackson County Schneck Memorial Hospital CurrentSince May 18, 2024 Accepting new patients
Seymour Indiana Pathologists, Inc Past Accepting new patients
Major Hospital Past Accepting new patients
Josephson-Wallack-Munshower Neurology PC Past Accepting new patients

Locations

12188A N Meridian St
Ste 320
Carmel, IN 46032
Phone (317) 580-0420

6983 Hillsdale Ct
Indianapolis, IN 46250

7250 Clearvista Dr
Ste 225
Indianapolis, IN 46256
Phone (317) 537-6088

1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555

2330 S Dixon Rd
Ste 325
Kokomo, IN 46902
Phone (765) 455-8822

2330 S Dixon Rd
Kokomo, IN 46902
Phone (765) 455-5400

330 N Wabash Ave
Ste 470
Marion, IN 46952
Phone (765) 455-8822

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

200 S Walnut St
Seymour, IN 47274
Phone (812) 522-2349

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1891704565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6983 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502054",
            "telephone_number": "317-849-8350",
            "fax_number": "317-576-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 S DIXON RD STE 325",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026430",
            "telephone_number": "765-455-8822",
            "fax_number": "765-865-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JATLA",
        "first_name": "SRIDHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01063214A",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "IN",
            "license": "01063214A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200903530",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@jwmn.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2330 S Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.