Dr Rudy Hartono Taarea, MD is a medicare enrolled "Preventive Medicine - Aerospace Medicine" physician in Opp, Alabama. His current practice location is
511 Brantley St, Opp, Alabama. You can reach out to his office (for appointments etc.) via phone at
(334) 493-3240.
Dr Rudy Hartono Taarea is licensed to practice in Alabama (license number AL19483) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336121862.
Physician's Profile
Full Name | Dr Rudy Hartono Taarea |
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Gender | Male |
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Speciality | Preventive Medicine - Aerospace Medicine |
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Location | 511 Brantley St, Opp, Alabama |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1336121862
- Provider Enumeration Date: 11/18/2005
- Last Update Date: 11/20/2012
Medicare PECOS Information:
- PECOS PAC ID: 2860640695
- Enrollment ID: I20120919000528
Medical Identifiers
Medical identifiers for Dr Rudy Hartono Taarea such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336121862 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2083A0100X | Preventive Medicine - Aerospace Medicine | AL19483 (Alabama) | 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. Dr Rudy Hartono Taarea allows following entities to bill medicare on his behalf.
Entity Name | Franklin Primary Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1679532303 PECOS PAC ID: 1658356308 Enrollment ID: O20040618000827 |
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Entity Name | Vincentian Physician Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1851698310 PECOS PAC ID: 1557548161 Enrollment ID: O20110608000452 |
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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. Dr Rudy Hartono Taarea 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 |
Dr Rudy Hartono Taarea, MD 511 Brantley St, Opp, AL 36467-1702 Ph: (334) 493-3240 | Dr Rudy Hartono Taarea, MD 511 Brantley St, Opp, AL 36467-1702 Ph: (334) 493-3240 |
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