Dr Evan Tirtaputra, DPT in Elkton, MD - Medicare Physical Therapist Provider

Dr Evan Tirtaputra, DPT is a medicare enrolled "Physical Therapist" provider in Elkton, Maryland. His current practice location is 137 W High St Ste 3, Elkton, Maryland. You can reach out to his office (for appointments etc.) via phone at (410) 392-7027.

Dr Evan Tirtaputra is licensed to practice in Maryland (license number 27800) 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 1083001234.

Contact Information

	Dr Evan Tirtaputra, DPT
	137 W High St Ste 3, Elkton, MD 21921
	(410) 392-7027
	(410) 392-5768

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Evan Tirtaputra
Gender	Male
Speciality	Physical Therapist
Location	137 W High St Ste 3, Elkton, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083001234
Provider Enumeration Date: 04/24/2015
Last Update Date: 11/26/2019

Medicare PECOS Information:

PECOS PAC ID: 2264723238
Enrollment ID: I20160622000849

Medical Identifiers

Medical identifiers for Dr Evan Tirtaputra such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083001234	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT-3844 (Idaho)	Secondary
225100000X	Physical Therapist	27800 (Maryland)	Primary
225100000X	Physical Therapist	J1-0003931 (Delaware)	Secondary

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. Dr Evan Tirtaputra allows following entities to bill medicare on his behalf.

Provider Name	Huntington Orthopedic Surgical Group
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1851465603 PECOS PAC ID: 8224026596 Enrollment ID: O20040505000088

Provider Name	Good Day Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1730768011 PECOS PAC ID: 9638570930 Enrollment ID: O20211123003330

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. Dr Evan Tirtaputra 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
Dr Evan Tirtaputra, DPT 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: (630) 296-2222	Dr Evan Tirtaputra, DPT 137 W High St Ste 3, Elkton, MD 21921 Ph: (410) 392-7027

Reviews and Comments

Physical Therapist in Elkton, MD

Mrs. Janelle Kristen Antonio, DPT, OCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 107 Chesapeake Blvd, Suite 100, Elkton, MD 21921 Phone: 410-392-9400 Fax: 410-392-0577
Paula Marie Giannaras, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 112 Paige Ln, Elkton, MD 21921 Phone: 410-920-8463
Maryann Taft, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 139 E High St, Elkton, MD 21921 Phone: 410-392-2731 Fax: 410-392-2732
Kathleen Lester Lechette, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 Booth St, Elkton, MD 21921 Phone: 410-996-5450
Ms. Heather E Wray, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 107 Chesapeake Blvd, Suite 100, Elkton, MD 21921 Phone: 410-392-9400 Fax: 410-392-0577
Maryanne Snyder, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 913 N Bridge St, Elkton, MD 21921 Phone: 410-392-2731 Fax: 410-392-2732

Dr Evan Tirtaputra, DPT - Medicare Physical Therapist in Elkton, MD