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

MS. Sreesubha P Chittamooru, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1639454960

MS. Sreesubha P Chittamooru, PHYSICIANASSISTANT is a Physician Assistant in Worcester, Massachusetts. Qualified in 2011, 15 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Connecticut and Massachusetts.

Years since qualifying
15
Licensed in
CT, MA
In the registry since
2011
Specialties on file
3
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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 334-0605
Fax: (508) 856-5074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 34 Maple St, Norwalk, CT 06850 — (203) 852-2188
  • 41 Mall Rd, Burlington, MA 01805-0002 — (781) 744-8085
  • 55 Lake Ave N, Worcester, MA 01655-0002 — (774) 443-7552

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA4578 (MA)
Physician Assistant Taxonomy 363A00000X · Licence 2665 (CT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2665 (CT)

Record details

NPI number1639454960
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedOctober 18, 2011
Last updated in NPPESNovember 6, 2024
Certification dateNovember 6, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Worcester