Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Srinivas Ketharaju, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1346416559

Dr. Srinivas Ketharaju, MD is an Obstetrics/Gynecology in Ogdensburg, New York. Qualified in 2004, 22 years ago. Practices with Mary Imogene Bassett Hospital, a 779-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kentucky, Massachusetts and New York.

Years since qualifying
22
Licensed in
KY, MA, NY
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3 Lyon Pl
Ogdensburg, NY 13669-2590
Phone: (315) 713-6700
Fax: (866) 816-0815
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 355 Waverly Oaks Rd Ste 275, Waltham, MA 02452-8477 — (781) 893-5550

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 280458 (NY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 43564 (KY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 1016377 (MA)

Record details

NPI number1346416559
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 7, 2008
Last updated in NPPESAugust 29, 2024
Certification dateAugust 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Mary Imogene Bassett Hospital — 779 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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