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

Suriya Sridaran, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1174367171

Suriya Sridaran, PHYSICIANASSISTANT is a Physician Assistant in Worcester, Massachusetts. Qualified in 2024, 2 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2024
Specialties on file
3
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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 334-3278
Fax: (508) 334-7284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA100887 (MA)
Medical Physician Assistant Taxonomy 363AM0700X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1174367171
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJune 24, 2024
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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