Sara Supriyatno, DDS - Medicare in Philadelphia, PA

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Sara Supriyatno, DDS is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Philadelphia, Pennsylvania. Her current practice location is 909 Walnut St Rm 300, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 503-7118.

Sara Supriyatno is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225775778.

Contact Information

Sara Supriyatno, DDS
909 Walnut St Rm 300,
Philadelphia, PA 19107-5211
(215) 503-7118
(215) 923-9189

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Healthcare Provider's Profile

Full NameSara Supriyatno
GenderFemale
SpecialityStudent In An Organized Health Care Education/training Program
Location909 Walnut St Rm 300, Philadelphia, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1225775778
  • Provider Enumeration Date: 05/17/2022
  • Last Update Date: 01/09/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9537693627
  • Enrollment ID: I20241112002995

Medical Identifiers

Medical identifiers for Sara Supriyatno such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225775778NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice DS043687 (Pennsylvania)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Primary

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. Sara Supriyatno 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 AddressPractice Location Address
Sara Supriyatno, DDS
909 Walnut St Rm 300,
Philadelphia, PA 19107-5211

Ph: (215) 503-7118		Sara Supriyatno, DDS
909 Walnut St Rm 300,
Philadelphia, PA 19107-5211

Ph: (215) 503-7118

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.