Juwono Lindawati Sutedjo, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

C180691 Issued in CA

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 723-4000

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Cardiovascular Disease (Cardiology)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stanford Health Care Hospital, Stanford, CA, CCN 050441
• Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
• Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsutedjo1043368@wm.providencedirect.org
• Direct secure messaging: jsutedjo455456@direct.stanfordhealthcare.org
• Direct secure messaging: jsutedjo1043407@oc.providencedirect.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.

• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Stanford Health Care

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  Care Compare affiliation
• Stanford Health Care

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758

  Hospital

  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1285177337
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1467990465
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1871543215
  Care Compare affiliation
• Stanford Health Care Tri-Valley

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1144389941
  Care Compare affiliation
• Stanford Life Flight

  • Air Ambulance
  • Stanford, CA
  • NPI 1114063203

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1114072980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Lynch Creek Way Ste C",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949542390",
            "country_code": "US",
            "telephone_number": "707-790-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Madison St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043599",
            "country_code": "US",
            "telephone_number": "206-505-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTEDJO",
        "first_name": "JUWONO",
        "middle_name": "LINDAWATI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "21983",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "228744",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MT",
            "license": "21983",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "CA",
            "license": "C180691",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C180691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsutedjo1043368@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1101 Madison St Ste 301",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981043599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsutedjo1043368@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "601 S Carr Rd Ste 100",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsutedjo1043368@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "31833 Gateway Center Blvd S",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980035616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsutedjo1043368@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "10416 5th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981257402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "901 Nevin Ave",
            "city": "Richmond",
            "state": "CA",
            "country_code": "US",
            "postal_code": "948013143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Suppes, MD PHD
• Gayatri Suresh Kumar, MD
• Katherine Susskind, MAT, ATC
• Sophia Sussman, MS, CGC
• Steven Sust, MD
• Katherine Calafia Sutherland, PA-C
• Kara S Sutton, NP
• Ryo Suzuki
• David Michael Svec, MD MBA
• John Anthony Swanner, L.AC.

• Cardiovascular Disease Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.