Dr Yudi Wibisono, DO - Medicare Preventive Medicine in North Las Vegas, NV

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Dr Yudi Wibisono, DO is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in North Las Vegas, Nevada. His current practice location is 6900 N Pecos Rd, North Las Vegas, Nevada. You can reach out to his office (for appointments etc.) via phone at (702) 791-9000.

Dr Yudi Wibisono is licensed to practice in Washington (license number OP61182777) 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 1740711134.

Contact Information

Dr Yudi Wibisono, DO
6900 N Pecos Rd,
North Las Vegas, NV 89086-4400
(702) 791-9000
Not Available

Map and Direction




Physician's Profile

Full NameDr Yudi Wibisono
GenderMale
SpecialityPreventive Medicine - Occupational Medicine
Location6900 N Pecos Rd, North Las Vegas, Nevada
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1740711134
  • Provider Enumeration Date: 03/27/2017
  • Last Update Date: 10/13/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5092087239
  • Enrollment ID: I20200813001493

Medical Identifiers

Medical identifiers for Dr Yudi Wibisono such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1740711134NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine MRO-1647 (Idaho)Secondary
2083P0500XPreventive Medicine - Preventive Medicine/occupational Environmental Medicine MRO-1647 (Idaho)Secondary
2083X0100XPreventive Medicine - Occupational Medicine 10964114-1204 (Utah)Secondary
2083X0100XPreventive Medicine - Occupational Medicine OP61182777 (Washington)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 Yudi Wibisono allows following entities to bill medicare on his behalf.
Entity NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710
Entity NameBridgeside Telehealth
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861153785
PECOS PAC ID: 7012300486
Enrollment ID: O20220302001880

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 Yudi Wibisono 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
Dr Yudi Wibisono, DO
6900 N Pecos Rd,
North Las Vegas, NV 89086-4400

Ph: (702) 791-9000		Dr Yudi Wibisono, DO
6900 N Pecos Rd,
North Las Vegas, NV 89086-4400

Ph: (702) 791-9000

Reviews and Comments


Preventive Medicine Doctors in North Las Vegas, NV

Dr. Ian Joseph Penniston, D.O.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 6900 N Pecos Rd, North Las Vegas, NV 89086
Phone: 702-791-9000    
Amir K. Nicknam, M.D.
Preventive Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 151 W Brooks Ave, Suite A, North Las Vegas, NV 89030
Phone: 615-778-4066    Fax: 615-778-9114
Judith L Salz, M.D.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 3945 W Cheyenne Ave, Ste 208, North Las Vegas, NV 89032
Phone: 702-648-8116    Fax: 702-648-8259
Dr. Ping Gao, M.D., M.P.H.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 6900 N Pecos Rd, North Las Vegas, NV 89086
Phone: 702-791-9000    
Dr. William Seaver Hill, M.D., M.P.H.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 6900 N Pecos Rd, North Las Vegas, NV 89086
Phone: 702-791-9013    
Dr. Jeff C Moon, D.O.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2621 Losee Rd, North Las Vegas, NV 89030
Phone: 702-295-6566    Fax: 702-295-4323

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.