Individual provider Active NPI

John Robert Hartono, MD

  • Nephrology Physician
  • Garland, TX
National Provider Identifier
1477576965
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
P0223 Issued in TX
Practice address
7150 N President George Bush Hwy Ste 205
Garland, TX 75044-2210
Phone
(972) 276-0139
Fax
(972) 276-0149
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X P0223 TX Primary

Addresses

Primary practice location

7150 N President George Bush Hwy Ste 205
Garland, TX 75044-2210

Mailing address

4708 Alliance Blvd
Suite 600
Plano, TX 75093-5340
Phone (469) 467-0011

Other practice location 1

4708 Alliance Blvd Ste 600
Plano, TX 75093-5368
Phone (469) 467-0011

Other identifiers 2

IdentifierTypeStateIssuer
285504101MedicaidTX
285504102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20111109000160 TX Practitioner - NephrologyPractitioner - Internal Medicine 5890968713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Minnesota Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Kidney Care of North Texas, P.L.L.C.Group PAC ID 6002957271, 8 clinicians

Practice addresses (Care Compare)

7150 N President George Bush Hwy
Suite 205
Garland, TX 75044-2210
Phone (972) 276-0139

Hospital & facility affiliations

  • DaVita Garland Dialysis Dialysis facility, Garland, TX, CCN 672555
  • DaVita Wylie Dialysis Dialysis facility, Wylie, TX, CCN 672702
  • Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025
  • Baylor Scott and White Medical Center McKinney Hospital, MC Kinney, TX, CCN 670082
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Encompass Health Rehabilitation Hospital of Plano Inpatient rehabilitation facility, Plano, TX, CCN 453047

Merit-based Incentive Payment System (MIPS)

Final score
88.38 of 100Reported as group
Quality
73.64
Promoting interoperability
98
Improvement activities
40
Cost
72.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Kidney Care of North Texas, P.L.L.C. Nephrology CurrentSince Sep 1, 2012 Accepting new patients
Advanced Kidney Care of North Texas, P.L.L.C. Nephrology CurrentSince Sep 1, 2012 Accepting new patients

Locations

7150 N President George Bush Hwy
Ste 205
Garland, TX 75044
Phone (972) 276-0139

4708 Alliance Blvd
Ste 600
Plano, TX 75093
Phone (469) 467-0011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2940/brand/1/csg/1/fhir/r4
  • Direct secure messaging: john.hartono.1@2940.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1477576965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 ALLIANCE BLVD",
            "address_2": "SUITE 600",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935340",
            "telephone_number": "469-467-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 N PRESIDENT GEORGE BUSH HWY STE 205",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442210",
            "telephone_number": "972-276-0139",
            "fax_number": "972-276-0149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4708 Alliance Blvd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750935368",
            "country_code": "US",
            "telephone_number": "469-467-0011",
            "fax_number": "469-467-4923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTONO",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P0223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285504101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285504102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.