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IRAWAN SUSANTO MD
NPI 1003836610
Internal Medicine - Critical Care Medicine in Santa Monica, CA

Active since July 20, 2006PECOS Enrolled
86.1/100
CMS Quality Rating
1223 16TH ST, SUITE 3400, SANTA MONICA, CA 90404(310) 449-0939(424) 259-7790 Get Directions Write a Review

NPPES record last updated: February 6, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Irawan Susanto Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IRAWAN SUSANTO MD (NPI 1003836610) is an individual critical care medicine provider in Santa Monica, California, licensed in California (C50280) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003836610
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameIRAWAN SUSANTOCredential: MD
Location Address1223 16TH ST, SUITE 3400Santa Monica, CA 90404-1217
Mailing Address5767 W Century Blvd, Suite 200Los Angeles, CA 90045-5632 · (310) 301-8708 · Fax (310) 301-8751
Phone(310) 449-0939
Fax(424) 259-7790
Sole ProprietorNo
Enumeration DateJuly 20, 2006
Last NPPES UpdateFebruary 6, 2014
✔ NPI 1003836610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in CA · C50280
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License C50280 (CA)
1223 16TH ST, Santa Monica, CA 90404
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Other Identifiers 5

Medicare PINWC50280BCA
Medicaid00C502800CA
Medicare PINWC50280ACA
Medicare PINWC50280CCA
Medicare UPIND95824CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Irawan Susanto Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
143 services22 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
25 services11 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
24 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90404 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.93
Promoting Interoperability100
Improvement Activities40
Cost66.73

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier12 claims12 services$3.92 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers15 claims15 services$67.22 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGORY BION BIERER MD
Internal Medicine (Pulmonary Disease)
1223 16TH ST, SUITE 3400
SANTA MONICA, CA 90404
Los Angeles County (310) 449-0939
ALISHIA KING
Pharmacist
1223 16TH ST
SANTA MONICA, CA 90404
Los Angeles County (310) 206-3784
SENTIA IRIANA M.D.
Internal Medicine (Transplant Hepatology)
1223 16TH ST
SANTA MONICA, CA 90404
Los Angeles County (310) 825-2631
GERARD WILLIAM FRANK MD
Internal Medicine (Pulmonary Disease)
1223 16TH ST, SUITE 3400
SANTA MONICA, CA 90404
Los Angeles County (310) 449-0939

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Irawan Susanto's NPI number?

The NPI number for Irawan Susanto is 1003836610. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Irawan Susanto located?

Irawan Susanto practices at 1223 16th St Suite 3400, Santa Monica, CA 90404. The listed phone number is (310) 449-0939.

What is Irawan Susanto's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Irawan Susanto enrolled in Medicare?

Yes. Irawan Susanto is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Irawan Susanto was last updated on February 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.