Mr Indra Soerja Oetomo, PT, LAC is a medicare enrolled "Physical Therapist - Orthopedic" provider in Highlands Ranch, Colorado. He graduated from medical school in 1984 and has 40 years of diverse experience with area of expertise as Physical Therapy. His current practice location is
8955 S Ridgeline Blvd, Suite 400, Highlands Ranch, Colorado. You can reach out to his office (for appointments etc.) via phone at
(303) 683-8338.
Mr Indra Soerja Oetomo is licensed to practice in Colorado (license number 3579) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1326005745.
Healthcare Provider's Profile
| Full Name | Mr Indra Soerja Oetomo |
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| Gender | Male |
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| Speciality | Physical Therapy |
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| Experience | 40 Years |
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| Location | 8955 S Ridgeline Blvd, Highlands Ranch, Colorado |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Indra Soerja Oetomo graduated from medical school in 1984
NPI Data:
- NPI Number: 1326005745
- Provider Enumeration Date: 04/28/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8224928460
- Enrollment ID: I20040614000456
Medical Identifiers
Medical identifiers for Mr Indra Soerja Oetomo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1326005745 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 171100000X | Acupuncturist | 978 (Colorado) | Primary |
| 2251X0800X | Physical Therapist - Orthopedic | 3579 (Colorado) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Indra Soerja Oetomo allows following entities to bill medicare on his behalf.
| Provider Name | Meromed Physiotherapy Centre Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1902983950
PECOS PAC ID: 8628968872
Enrollment ID: O20110616000144 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Indra Soerja Oetomo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Indra Soerja Oetomo, PT, LAC
8955 S Ridgeline Blvd, Suite 400,
Highlands Ranch, CO 80129-2362
Ph: (303) 683-8338 | Mr Indra Soerja Oetomo, PT, LAC
8955 S Ridgeline Blvd, Suite 400,
Highlands Ranch, CO 80129-2362
Ph: (303) 683-8338 |
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