Ni Ketut Kumala Dewi Hariadi, - Medicare Nurse Practitioner in Independence, OH

Ni Ketut Kumala Dewi Hariadi, is a medicare enrolled "Nurse Practitioner" in Independence, Ohio. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Cleveland Clinic Foundation and her current practice location is 5001 Rockside Rd, Independence, Ohio. You can reach out to her office (for appointments etc.) via phone at (216) 986-4000.

Ni Ketut Kumala Dewi Hariadi is licensed to practice in Ohio (license number AG07180050) 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 1114404159.

Contact Information

Ni Ketut Kumala Dewi Hariadi,
5001 Rockside Rd,
Independence, OH 44131-2172
(216) 986-4000
Not Available



Provider's Profile

Full NameNi Ketut Kumala Dewi Hariadi
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location5001 Rockside Rd, Independence, Ohio
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:
  • Ni Ketut Kumala Dewi Hariadi graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1114404159
  • Provider Enumeration Date: 07/23/2018
  • Last Update Date: 07/23/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 2860736071
  • Enrollment ID: I20181128003475

Medical Identifiers

Medical identifiers for Ni Ketut Kumala Dewi Hariadi such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114404159NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner AG07180050 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Cleveland ClinicCleveland, OHHospital
Akron General Medical CenterAkron, OHHospital
Marymount HospitalGarfield heights, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Cleveland Clinic Foundation18502035555690

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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. Ni Ketut Kumala Dewi Hariadi allows following entities to bill medicare on her behalf.
Entity NameThe Cleveland Clinic Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679525919
PECOS PAC ID: 1850203555
Enrollment ID: O20031103000049

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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. Ni Ketut Kumala Dewi Hariadi 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
Ni Ketut Kumala Dewi Hariadi,
9000 Moss Pointe Cir,
Olmsted Twp, OH 44138-8168

Ph: (216) 258-3660
Ni Ketut Kumala Dewi Hariadi,
5001 Rockside Rd,
Independence, OH 44131-2172

Ph: (216) 986-4000

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A report released on Monday by the Asia Society and the International Rice Research Institute recommends that Asian countries should increase rice reserves to help stabilize prices and improve food security in the region which is home to about 65 percent of the world's hungry, Bloomberg reports.

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Nurse Practitioner Nurses in Independence, OH

Susan E Reif, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6801 Brecksville Rd, Suite 10, Independence, OH 44131
Phone: 216-444-4663    Fax: 216-636-8839
Colleen Theresa Coleman, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 5001 Rockside Rd, Independence, OH 44131
Phone: 440-278-1002    
Karla Dey,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6100 Rockside Woods Blvd N, Suite 425, Independence, OH 44131
Phone: 216-643-2780    Fax: 216-524-0111
Luann Etcher, N.P.
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6150 Oak Tree Blvd, Suite 200, Independence, OH 44131
Phone: 800-897-9177    Fax: 800-470-8713
Sandra Chlad, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6801 Brecksville Rd, Rk10, Independence, OH 44131
Phone: 216-444-4663    
Baoanh Chu,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6150 Oak Tree Blvd Ste 200, Independence, OH 44131
Phone: 954-850-3444    
Ms. Mary E Elchlinger, CNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6100 Rockside Woods Blvd N, Suite 425, Independence, OH 44131
Phone: 216-643-2780    Fax: 216-524-0111

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