Michael Leon Tjahjadi, MD in Statesville, NC

Michael Leon Tjahjadi, MD is a medicare enrolled "Pediatrics" physician in Statesville, North Carolina. His current practice location is 728 Hartness Rd, Statesville, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 360-6420.

Michael Leon Tjahjadi is licensed to practice in North Carolina (license number 2023-02709) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699188912.

Contact Information

	Michael Leon Tjahjadi, MD
	728 Hartness Rd, Statesville, NC 28677-3425
	(704) 360-6420
	Not Available

Map and Direction

Physician's Profile

Full Name	Michael Leon Tjahjadi
Gender	Male
Speciality	Pediatrics
Location	728 Hartness Rd, Statesville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1699188912
Provider Enumeration Date: 06/04/2014
Last Update Date: 07/28/2025

Medicare PECOS Information:

PECOS PAC ID: 0941596910
Enrollment ID: I20231207003540

Medical Identifiers

Medical identifiers for Michael Leon Tjahjadi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699188912	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	2023-02709 (North Carolina)	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. Michael Leon Tjahjadi allows following entities to bill medicare on his behalf.

Entity Name	Iredell Physician Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811381593 PECOS PAC ID: 0749345007 Enrollment ID: O20090219000651

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. Michael Leon Tjahjadi 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
Michael Leon Tjahjadi, MD 200 E 2nd Ave, Gastonia, NC 28052-4358 Ph: (704) 874-1904	Michael Leon Tjahjadi, MD 728 Hartness Rd, Statesville, NC 28677-3425 Ph: (704) 360-6420

Reviews and Comments

Pediatrics Doctors in Statesville, NC

Dr. Jon Ryan Hutchinson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 558 Kitchings Dr, Statesville, NC 28677 Phone: 704-838-8255 Fax: 704-871-9099
Elizabeth Whitley Fickling Rashley, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 129 Sherlock Dr, Statesville, NC 28625 Phone: 704-838-8245
Ellyn Pearson Mullis, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1022 Shelton Ave, Statesville, NC 28677 Phone: 704-768-2088 Fax: 704-768-2081
Geoffrey Alan Abell, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 925 Thomas St Ste A, Statesville, NC 28677 Phone: 704-872-9595 Fax: 704-872-5851
Walter Curtis Gessler, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 129 Sherlock Dr, Statesville, NC 28625 Phone: 704-838-8245
Andrea Evbu Iyekepolo, Pediatrics Medicare: Medicare Enrolled Practice Location: 129 Sherlock Dr, Statesville, NC 28625 Phone: 704-838-8245 Fax: 704-924-4282
Tara Moon, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1410 Fern Creek Dr, Statesville, NC 28625 Phone: 704-978-2379 Fax: 704-978-2380

Michael Leon Tjahjadi, MD - Medicare Pediatrics in Statesville, NC