Paul Sugiharto

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95010196 Issued in CA

Practice address

425 W Main St Ste 101
Alhambra, CA 91801-7439

Phone

(626) 382-1252

NPI assigned

Nov 7, 2018

Last updated

Feb 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Stephen P Chen MD Inc

  • Pulmonary Disease Physician
  • Monterey Park, CA
  • NPI 1841517067
  Medicare reassignment NPD
• Jaya Healthcare Nursing Inc.

  • Family Nurse Practitioner
  • Alhambra, CA
  • NPI 1295434777
  NPD Authorized official

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1619445665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12143 LAMBERT AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917322055",
            "telephone_number": "626-590-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W MAIN ST STE 101",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017439",
            "telephone_number": "626-382-1252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12143 Lambert Ave",
            "address_purpose": "LOCATION",
            "city": "El Monte",
            "state": "CA",
            "postal_code": "917322055",
            "country_code": "US",
            "telephone_number": "626-590-1404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUGIHARTO",
        "first_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95010196",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "744628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rong Yeh Su
• Yuhao Su, D.C.
• Subadya Chiropractic,Inc.
• Kornelius Tjandra Subadya, DC
• Kimiko Suehiro
• Bridget M. Suleiman, LCSW
• Samantha Sullivan
• Sum Li, DDS, Inc.
• Summerville at Cobbco, Inc. (Brookdale Alhambra)
• Elaine Sun

• Family Nurse Practitioner in Alhambra, CA
• Providers in Alhambra, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.