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

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 NameJuwono Sutedjo
GenderFemale
SpecialityInternal Medicine
Experience18 Years
Location141 Lynch Creek Way Ste C, Petaluma, California
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1114072980NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 21983 (Montana)Secondary
207R00000XInternal Medicine 228744 (Massachusetts)Secondary
207RC0000XInternal Medicine - Cardiovascular Disease C180691 (California)Primary
207RC0000XInternal Medicine - Cardiovascular Disease 21983 (Montana)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Petaluma Valley HospitalPetaluma, CAHospital
Santa Rosa Memorial HospitalSanta rosa, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Medical Foundation89219932051312

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 NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710
Entity NameProvidence Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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

Timothy M Sowerby, MD
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Dr. Gerald S. Besses, MD
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Dr. Jeffrey Tobias, MD
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Dr. Thomas Paton Knecht, MD, PHD
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Medicare: Medicare Enrolled
Practice Location: 141 Lynch Creek Way, Suite A, Petaluma, CA 94954
Phone: 707-762-0001    

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.