Kenny Susanto, MD in Tulsa, OK - Medicare Neurology

Kenny Susanto, MD is a medicare enrolled "Psychiatry & Neurology - Neurology" physician in Tulsa, Oklahoma. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Neurology. He is a member of the group practice St John Physicians Inc and his current practice location is 2000 S Wheeling Ave Ste 701, Tulsa, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (918) 748-7810.

Kenny Susanto is licensed to practice in Oklahoma (license number 38794) 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 1255783270.

Contact Information

	Kenny Susanto, MD
	2000 S Wheeling Ave Ste 701, Tulsa, OK 74104-5647
	(918) 748-7810
	Not Available

Map and Direction

Physician's Profile

Full Name	Kenny Susanto
Gender	Male
Speciality	Neurology
Experience	12 Years
Location	2000 S Wheeling Ave Ste 701, Tulsa, Oklahoma
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kenny Susanto graduated from medical school in 2012

NPI Data:

NPI Number: 1255783270
Provider Enumeration Date: 07/02/2016
Last Update Date: 06/27/2022

Medicare PECOS Information:

PECOS PAC ID: 1254758410
Enrollment ID: I20220815001112

Medical Identifiers

Medical identifiers for Kenny Susanto such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255783270	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084N0400X	Psychiatry & Neurology - Neurology	1.065004 (Connecticut)	Secondary
2084N0400X	Psychiatry & Neurology - Neurology	008863 (Georgia)	Secondary
2084N0400X	Psychiatry & Neurology - Neurology	38794 (Oklahoma)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St John Medical Center, Inc	Tulsa, OK	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
St John Physicians Inc	2567366495	221

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. Kenny Susanto allows following entities to bill medicare on his behalf.

Entity Name	St John Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336194406 PECOS PAC ID: 2567366495 Enrollment ID: O20031121000867

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. Kenny Susanto 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
Kenny Susanto, MD 2000 S Wheeling Ave Ste 701, Tulsa, OK 74104-5647 Ph: () -	Kenny Susanto, MD 2000 S Wheeling Ave Ste 701, Tulsa, OK 74104-5647 Ph: (918) 748-7810

Reviews and Comments

Psychiatry & Neurology Doctors in Tulsa, OK

David Leroy Mcelwain, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 4111 S Darlington Ave, Suite 425, Tulsa, OK 74135 Phone: 866-285-4381 Fax: 918-712-9883
Dr. Smit Dilipkumar Patel, MBBS, MPH Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 6475 S Yale Ave Ste 308, Tulsa, OK 74136 Phone: 918-499-4000 Fax: 918-499-4001
Sara Verga, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1055 S Houston Ave, Tulsa, OK 74127 Phone: 918-921-3200 Fax: 918-560-1399
Charles Hayward Hill, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 5330 E 31st St Ste 800, Tulsa, OK 74135 Phone: 918-664-9000 Fax: 918-664-9922
Phillip Joseph Leon, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 6655 S Yale Ave, Laureate Psychiatric Clinic And Hospital, Tulsa, OK 74136 Phone: 918-491-3762 Fax: 918-491-5740
Dr. Jackie Lynn Neel, DO Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 6655 S Yale Ave, Laureate Psychiatric Clinic And Hospital, Tulsa, OK 74136 Phone: 918-502-5052 Fax: 918-502-5060
Dr. Tara Romasanta Buck, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 4444 E 41st St, Tulsa, OK 74135 Phone: 918-660-3130 Fax: 918-660-3132

Kenny Susanto, MD - Medicare Neurology in Tulsa, OK