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MATTHEW TJAHJADI
NPI 1154216810
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since June 11, 2025
525 VINE ST, WINSTON SALEM, NC 27101(336) 716-1411 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Matthew Tjahjadi NPPES

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

MATTHEW TJAHJADI (NPI 1154216810) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1154216810
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMATTHEW TJAHJADI
Location Address525 VINE STWinston Salem, NC 27101-4125
Mailing Address525 Vine StWinston Salem, NC 27101-4125 · (336) 716-1411
Phone(336) 716-1411
Sole ProprietorNo
Enumeration DateJune 11, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1154216810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
525 VINE ST, Winston Salem, NC 27101
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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.

SAMUEL PARKER CONNELL
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
KATELYN PAIGE WATTERS
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
ALEXA KASS
Nurse Anesthetist, Certified Registered
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
LUCY WILLIAMS SHULER
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
MADELINE GRINER
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
LUCY HERNANDEZ
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
ERIN RIDDLE SRNA
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411
ADAM WYNN
Student in an Organized Health Care Education/Training Program
525 VINE ST
WINSTON SALEM, NC 27101
Forsyth County (336) 716-1411

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 Matthew Tjahjadi's NPI number?

The NPI number for Matthew Tjahjadi is 1154216810. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Matthew Tjahjadi located?

Matthew Tjahjadi practices at 525 Vine St, Winston Salem, NC 27101. The listed phone number is (336) 716-1411.

What is Matthew Tjahjadi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Matthew Tjahjadi was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.