Nurul Itqiyah Hariadi, MD in Maricopa, AZ

Nurul Itqiyah Hariadi, MD is a medicare enrolled "Pediatrics" physician in Maricopa, Arizona. Her current practice location is 17900 N Porter Rd, Maricopa, Arizona. You can reach out to her office (for appointments etc.) via phone at (520) 233-2500.

Nurul Itqiyah Hariadi is licensed to practice in Michigan (license number 4301090456) 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 1881875037.

Contact Information

	Nurul Itqiyah Hariadi, MD
	17900 N Porter Rd, Maricopa, AZ 85138-4228
	(520) 233-2500
	(520) 233-2574

Map and Direction

Physician's Profile

Full Name	Nurul Itqiyah Hariadi
Gender	Female
Speciality	Pediatrics
Location	17900 N Porter Rd, Maricopa, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1881875037
Provider Enumeration Date: 11/15/2007
Last Update Date: 07/22/2016

Medicare PECOS Information:

PECOS PAC ID: 1951699495
Enrollment ID: I20161016000001

Medical Identifiers

Medical identifiers for Nurul Itqiyah Hariadi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881875037	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	4301090456 (Michigan)	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. Nurul Itqiyah Hariadi allows following entities to bill medicare on her behalf.

Entity Name	Banner Primary Care Physicians Arizona Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417238908 PECOS PAC ID: 6406020155 Enrollment ID: O20111115000898

Entity Name	Banner Childrens Banner Health Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407191216 PECOS PAC ID: 2466697735 Enrollment ID: O20130315000131

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. Nurul Itqiyah Hariadi 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
Nurul Itqiyah Hariadi, MD 17900 N Porter Rd, Maricopa, AZ 85138-4228 Ph: (520) 233-2500	Nurul Itqiyah Hariadi, MD 17900 N Porter Rd, Maricopa, AZ 85138-4228 Ph: (520) 233-2500

Reviews and Comments

Pediatrics Doctors in Maricopa, AZ

Elizabeth Ann Allen, CPNP-PC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21300 N John Wayne Pkwy Ste 112, Maricopa, AZ 85139 Phone: 520-568-9500
Dr. Marie Christianne Sandhya Ravi Chandar, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500
Dr. Rachel Singer, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500
Dr. James Michael Underwood, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 44572 W Bowlin Rd, Maricopa, AZ 85138 Phone: 520-568-2316 Fax: 520-568-2316
Carrie Ann Lipp, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 Fax: 520-233-2531
Dr. Dawn Medler Sorenson, M.D., M.P.H Pediatrics Medicare: Medicare Enrolled Practice Location: 17900 N Porter Rd, Maricopa, AZ 85138 Phone: 520-233-2500 Fax: 520-233-2531

Nurul Itqiyah Hariadi, MD - Medicare Pediatrics in Maricopa, AZ