Irawan Susanto, MD - Medicare Pulmonary Disease in Santa Monica, CA

Irawan Susanto, MD is a medicare enrolled "Internal Medicine - Critical Care Medicine" physician in Santa Monica, California. He went to University Of Texas Medical School At San Antonio and graduated in 1987 and has 37 years of diverse experience with area of expertise as Pulmonary Disease. He is a member of the group practice The Regents Of The University Of California and his current practice location is 1223 16th St, Suite 3400, Santa Monica, California. You can reach out to his office (for appointments etc.) via phone at (310) 449-0939.

Irawan Susanto is licensed to practice in California (license number C50280) 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 1003836610.

Contact Information

Irawan Susanto, MD
1223 16th St, Suite 3400,
Santa Monica, CA 90404-1217
(310) 449-0939
(424) 259-7790



Physician's Profile

Full NameIrawan Susanto
GenderMale
SpecialityPulmonary Disease
Experience37 Years
Location1223 16th St, Santa Monica, California
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Irawan Susanto attended and graduated from University Of Texas Medical School At San Antonio in 1987
  NPI Data:
  • NPI Number: 1003836610
  • Provider Enumeration Date: 07/20/2006
  • Last Update Date: 02/06/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 7113073503
  • Enrollment ID: I20090928000203

Medical Identifiers

Medical identifiers for Irawan Susanto such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003836610NPI-NPPES
00C502800MedicaidCA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RP1001XInternal Medicine - Pulmonary Disease C50280 (California)Secondary
207RC0200XInternal Medicine - Critical Care Medicine C50280 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ronald Reagan Ucla Medical CenterLos angeles, CAHospital
Santa Monica - Ucla Med Ctr & Orthopaedic HospitalSanta monica, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
The Regents Of The University Of California13552485841177

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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. Irawan Susanto allows following entities to bill medicare on his behalf.
Entity NameThe Regents Of The University Of California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235107566
PECOS PAC ID: 1355248584
Enrollment ID: O20031223000439

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Entity NameRancho Faculty Medical Associates, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750317970
PECOS PAC ID: 8022902469
Enrollment ID: O20040211000774

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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. Irawan Susanto 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
Irawan Susanto, MD
5767 W Century Blvd, Suite 200,
Los Angeles, CA 90045-5632

Ph: (310) 301-8708
Irawan Susanto, MD
1223 16th St, Suite 3400,
Santa Monica, CA 90404-1217

Ph: (310) 449-0939

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Internal Medicine Doctors in Santa Monica, CA

Louis Ravitz, MD
Critical Care Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2336 Santa Monica Blvd, Suite 207, Santa Monica, CA 90404
Phone: 310-828-9311    Fax: 310-453-8533
Janet Winikoff, MD
Critical Care Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2001 Santa Monica Blvd Ste 860, Santa Monica, CA 90404
Phone: 310-828-3209    Fax: 310-828-5165
Dr. Sean Dooley, M.D.
Critical Care Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2121 Santa Monica Blvd, Santa Monica, CA 90404
Phone: 323-829-8745    
Lorraine Anderson, MD
Critical Care Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1245 16th St Ste 303, Santa Monica, CA 90404
Phone: 310-481-4646    Fax: 310-899-7599
Dr. Colleen Lucy Channick, M.D.
Critical Care Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1223 16th St Ste 3400, Santa Monica, CA 90404
Phone: 310-449-0939    
Carol Yukiko Nishikubo, M.D.
Critical Care Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2001 Santa Monica Blvd Ste 560w, Santa Monica, CA 90404
Phone: 310-453-5654    Fax: 310-453-6885

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