Emanuel Bambang Kristianto, MD in Riverside, CA

Emanuel Bambang Kristianto, MD is a medicare enrolled "Family Medicine" physician in Riverside, California. His current practice location is 10800 Magnolia Ave, Riverside, California. You can reach out to his office (for appointments etc.) via phone at (909) 353-2000.

Emanuel Bambang Kristianto is licensed to practice in California (license number A88106) 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 1063589075.

Contact Information

	Emanuel Bambang Kristianto, MD
	10800 Magnolia Ave, Riverside, CA 92505-3043
	(909) 353-2000
	Not Available

Map and Direction

Physician's Profile

Full Name	Emanuel Bambang Kristianto
Gender	Male
Speciality	Family Medicine
Location	10800 Magnolia Ave, Riverside, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063589075
Provider Enumeration Date: 11/29/2006
Last Update Date: 12/03/2021

Medicare PECOS Information:

PECOS PAC ID: 5597790162
Enrollment ID: I20100825000903

Medical Identifiers

Medical identifiers for Emanuel Bambang Kristianto such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063589075	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	A88106 (California)	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. Emanuel Bambang Kristianto allows following entities to bill medicare on his behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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. Emanuel Bambang Kristianto 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
Emanuel Bambang Kristianto, MD 10800 Magnolia Ave, Riverside, CA 92505-3043 Ph: (909) 353-2000	Emanuel Bambang Kristianto, MD 10800 Magnolia Ave, Riverside, CA 92505-3043 Ph: (909) 353-2000

Reviews and Comments

Family Medicine Doctors in Riverside, CA

Miriam Cho, M.D Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7117 Brockton Ave, Riverside, CA 92506 Phone: 951-321-6504 Fax: 951-784-3271
Sung Jin John, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10800 Magnolia Ave, Riverside, CA 92505 Phone: 909-353-2000
Dr. Denise A Martinez, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3390 University Ave Ste 100, Riverside, CA 92501 Phone: 844-827-8000
Nathan Hao Hsin Yen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6405 Day St, Riverside, CA 92507 Phone: 951-697-5427 Fax: 951-697-5516
Dr. Janis Neuman, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 7140 Indiana Ave, Riverside, CA 92504 Phone: 951-358-6000 Fax: 951-358-6044
Wayne Dysinger, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4368 Central Ave, Riverside, CA 92506 Phone: 951-742-7324 Fax: 951-394-7267
Karl Tanara, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7117 Brockton Ave, Riverside, CA 92506 Phone: 951-782-3715 Fax: 951-784-3275

Emanuel Bambang Kristianto, MD - Medicare Family Medicine in Riverside, CA