1. Home
  2. Directory
  3. California
  4. Loma Linda
  5. Internal Medicine
  6. NPI Profile

DR. CONNY TIRTAMAN-SIE M.D
NPI 1043306947
Internal Medicine in Loma Linda, CA

Active since October 05, 2006PECOS Enrolled
11201 BENTON ST, LOMA LINDA, CA 92357(909) 825-7084(909) 583-6726 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Conny Tirtaman-sie M.d NPPES

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

DR. CONNY TIRTAMAN-SIE M.D (NPI 1043306947) is an individual internal medicine provider in Loma Linda, California, licensed in California (C52357) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043306947
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. CONNY TIRTAMAN-SIECredential: M.D
Location Address11201 BENTON STLoma Linda, CA 92357-1000
Mailing AddressPo Box 1576Loma Linda, CA 92354-1576 · (909) 825-7084 · Fax (909) 583-6726
Phone(909) 825-7084
Fax(909) 583-6726
Sole ProprietorNo
Enumeration DateOctober 5, 2006
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1043306947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in CA · C52357✔ Licensed in WA · MD00040886✔ Licensed in FL · ME0083971
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License C52357 (CA)
11201 BENTON ST, Loma Linda, CA 92357
Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Conny Tirtaman

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Conny Tirtaman-sie M.d 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92357 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
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

Other Providers at the Same Location NPPES 20

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

DR. ARTHUR CHUNG-LIUNG CHANG M.D.
Radiology (Diagnostic Radiology)
11201 BENTON ST, VA LOMA LINDA HEALTHCARE SYSTEM - DEPT OF RADIOLOGY
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
JUNGMI LEE LCSW
Social Worker (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PETRU PAPACOSTEA
Internal Medicine
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY J DALLMEIER RRT
Respiratory Therapist, Registered (Pulmonary Diagnostics)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
PATTY BEAVER LSW
Counselor (Mental Health)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 674-2794
DR. KRYSTAL GREGG PSYD
Psychologist (Clinical)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
HOLLY CORNEJO FNP-C
Nurse Practitioner (Family)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 825-7084
MELISSA SOLOMON-JACKSON
Registered Nurse (Emergency)
11201 BENTON ST
LOMA LINDA, CA 92357
San Bernardino County (909) 805-7084

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 Conny Tirtaman-sie's NPI number?

The NPI number for Conny Tirtaman-sie is 1043306947. It was assigned to this individual provider in the NPPES registry on October 5, 2006. The provider is also known as Dr. Conny Tirtaman.

Where is Conny Tirtaman-sie located?

Conny Tirtaman-sie practices at 11201 Benton St, Loma Linda, CA 92357. The listed phone number is (909) 825-7084.

What is Conny Tirtaman-sie's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Conny Tirtaman-sie enrolled in Medicare?

Yes. Conny Tirtaman-sie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Conny Tirtaman-sie was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.