Juwono Sutedjo, MD in Petaluma, CA - Medicare Internal Medicine

Juwono Sutedjo, MD is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Petaluma, California. She graduated from medical school in 2006 and has 18 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Providence Medical Foundation and her current practice location is 141 Lynch Creek Way Ste C, Petaluma, California. You can reach out to her office (for appointments etc.) via phone at (707) 790-8000.

Juwono Sutedjo is licensed to practice in California (license number C180691) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114072980.

Contact Information

	Juwono Sutedjo, MD
	141 Lynch Creek Way Ste C, Petaluma, CA 94954-2390
	(707) 790-8000
	Not Available

Map and Direction

Physician's Profile

Full Name	Juwono Sutedjo
Gender	Female
Speciality	Internal Medicine
Experience	18 Years
Location	141 Lynch Creek Way Ste C, Petaluma, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Juwono Sutedjo graduated from medical school in 2006

NPI Data:

NPI Number: 1114072980
Provider Enumeration Date: 01/24/2007
Last Update Date: 03/23/2023

Medicare PECOS Information:

PECOS PAC ID: 9638319015
Enrollment ID: I20221214000247

Medical Identifiers

Medical identifiers for Juwono Sutedjo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114072980	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	21983 (Montana)	Secondary
207R00000X	Internal Medicine	228744 (Massachusetts)	Secondary
207RC0000X	Internal Medicine - Cardiovascular Disease	C180691 (California)	Primary
207RC0000X	Internal Medicine - Cardiovascular Disease	21983 (Montana)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Santa Rosa Memorial Hospital	Santa rosa, CA	Hospital
Petaluma Valley Hospital	Petaluma, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Medical Foundation	8921993205	1293

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. Juwono Sutedjo allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

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. Juwono Sutedjo 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
Juwono Sutedjo, MD 1101 Madison St, Suite 301, Seattle, WA 98104 Ph: (206) 505-1020	Juwono Sutedjo, MD 141 Lynch Creek Way Ste C, Petaluma, CA 94954-2390 Ph: (707) 790-8000

Reviews and Comments

Internal Medicine Doctors in Petaluma, CA

Dr. Philippe Edouard, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1179 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500 Fax: 707-559-7620
Dr. Gerald S. Besses, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 124 Sunny Hill Dr, Petaluma, CA 94952 Phone: 707-658-2799
Dr. Jeffrey Tobias, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 10 Lavender Ter, Petaluma, CA 94952 Phone: 650-200-8944
Dr. Thomas Paton Knecht, MD, PHD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 141 Lynch Creek Way, Suite A, Petaluma, CA 94954 Phone: 707-762-0001
Stephen A. Weiss, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3900 Lakeville Hwy, Petaluma, CA 94954 Phone: 707-765-3900
Thomas Owen Maloney, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 108 Lynch Creek Way, #5, Petaluma, CA 94954 Phone: 707-763-6585 Fax: 707-763-2788

Juwono Sutedjo, MD - Medicare Internal Medicine in Petaluma, CA