Brady Supriadi, DPT in Fontana, CA - Medicare Physical Therapy Provider

Brady Supriadi, DPT is a medicare enrolled "Physical Therapist" provider in Fontana, California. He graduated from medical school in 2019 and has 5 years of diverse experience with area of expertise as Physical Therapy. He is a member of the group practice California Luna Care Physical Therapy Pc and his current practice location is 8545 Sierra Ave, Fontana, California. You can reach out to his office (for appointments etc.) via phone at (909) 365-3557.

Brady Supriadi is licensed to practice in California (license number PT301113) 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 1346905841.

Contact Information

	Brady Supriadi, DPT
	8545 Sierra Ave, Fontana, CA 92335-3868
	(909) 365-3557
	(909) 658-8987

Map and Direction

Healthcare Provider's Profile

Full Name	Brady Supriadi
Gender	Male
Speciality	Physical Therapy
Experience	5 Years
Location	8545 Sierra Ave, Fontana, California
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:

Brady Supriadi graduated from medical school in 2019

NPI Data:

NPI Number: 1346905841
Provider Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021

Medicare PECOS Information:

PECOS PAC ID: 9335530534
Enrollment ID: I20211223000592

Medical Identifiers

Medical identifiers for Brady Supriadi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346905841	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT301113 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
California Luna Care Physical Therapy Pc	9638427834	565

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. Brady Supriadi allows following entities to bill medicare on his behalf.

Provider Name	California Luna Care Physical Therapy Pc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1689162166 PECOS PAC ID: 9638427834 Enrollment ID: O20180803002123

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. Brady Supriadi 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
Brady Supriadi, DPT 8545 Sierra Ave, Fontana, CA 92335-3868 Ph: (909) 365-3557	Brady Supriadi, DPT 8545 Sierra Ave, Fontana, CA 92335-3868 Ph: (909) 365-3557

Reviews and Comments

Physical Therapist in Fontana, CA

Sheila Ann Vanallen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Building 3a, Fontana, CA 92335 Phone: 909-427-7727
Walter Tablante De Jesus, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13578 Hatcher Pl, Fontana, CA 92336 Phone: 909-641-1096
Paula Ann Shearer, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-4075
Jeanie Salvador, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Avenue, Fontana, CA 92335 Phone: 909-427-7900
Marissa Huma, Physical Therapist Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 951-295-4253
Ing Chang, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-4075
Dr. Candice Shearer, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 17284 Slover Ave, Fontana, CA 92337 Phone: 909-609-3800

Brady Supriadi, DPT - Medicare Physical Therapist in Fontana, CA