Individual provider Active NPI

Rio Sutikno-Ong, MD

  • Emergency Medicine Physician
  • Covina, CA
National Provider Identifier
1629104526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G42729 Issued in CA
Practice address
420 W San Bernardino Rd
Covina, CA 91723
Phone
(626) 915-6293
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G42729 CA Primary

Addresses

Primary practice location

420 W San Bernardino Rd
Covina, CA 91723

Mailing address

1438 E Holt Ave
Covina, CA 91724
Phone (626) 967-3213

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070605000354 CA Practitioner - Emergency Medicine 2769580331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gem Medical Group CorporationGroup PAC ID 3072984400, 54 clinicians

Practice addresses (Care Compare)

900 S Atlantic Blvd
Monterey Park, CA 91754-4716
Phone (877) 346-2211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42729CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients
Golden West Emergency Medical Associates, Inc Emergency Medicine CurrentSince Dec 12, 2015 Accepting new patients
Gem Medical Group Corporation Emergency Medicine CurrentSince Feb 1, 2023 Accepting new patients

Locations

900 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 457-7450

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

1701 Santa Anita Ave
South El Monte, CA 91733
Phone (626) 350-7916

9080 Colima Rd
Whittier, CA 90605
Phone (562) 907-1565

Organizations & group practices 3

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 2

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629104526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 E HOLT AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91724",
            "telephone_number": "626-967-3213",
            "fax_number": "626-918-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91723",
            "telephone_number": "626-915-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTIKNO-ONG",
        "first_name": "RIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G42729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.