Maria S Rahardja, DNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP60015757 Issued in WA

Practice address

1400 Jackson St
Denver, CO 80206-2762

Phone

(303) 388-4461

Fax

(303) 398-1211

NPI assigned

Oct 18, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Maria Susanto Former name

Medicare fee-for-service enrollment

Enrolled in WA, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138
• University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrahardja90050@direct.ehre.uwmedicine.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Association of University Physicians

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1023041159
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fred Hutchinson Cancer Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1164493847
  Care Compare affiliation
• Fred Hutchinson Cancer Center

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1356415699

  Hospital

  Care Compare affiliation
• University of Washington

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1326002049
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1104078377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062762",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062762",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHARDJA",
        "first_name": "MARIA",
        "middle_name": "S",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-18",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60015757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "SUSANTO",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael L Raggio, M.D.
• Jade Ragland
• Kam Ragland, LPCC
• Dominic Frank Damien Rago, MD, MBA
• Viswamitra Ragoonanan, M.D.
• John George Raheb, D.O.
• Kristy Lynn Rahimi-Alangi
• Mary B Rahoe-Wallace, PT
• Monta C Rahtjen, PT
• Shannon Rahwa, LPC

• Adult Health Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Adult Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.