STEPHANUS ERIC HARYADI M.D.
NPI 1174902498
Internal Medicine in Orwell, OH

Q: What is Stephanus Haryadi's NPI number?

The NPI number for Stephanus Haryadi is 1174902498. It was assigned to this individual provider in the NPPES registry on May 19, 2015.

Q: What is Stephanus Haryadi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Stephanus Haryadi was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 19, 2015PECOS EnrolledAccepts Medicare Assignment

90.9/100

CMS Quality Rating

315 E MAIN ST, ORWELL, OH 44076(440) 437-6222(440) 437-1022 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 3, 2021, Jul 26, 2019 (2 updates tracked since 2019).

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About Stephanus Eric Haryadi M.d. NPPES

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

STEPHANUS ERIC HARYADI M.D. (NPI 1174902498) is an individual internal medicine provider in Orwell, Ohio, licensed in Ohio (35.135310) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Metrohealth System, and is a graduate of Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University (2015).

NPPES Registry Identity

NPI1174902498

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSTEPHANUS ERIC HARYADICredential: M.D.

Location Address315 E MAIN STOrwell, OH 44076-9590

Mailing Address8055 Mayfield Rd Ste 105Chesterland, OH 44026-2447

Phone(440) 437-6222

Fax(440) 437-1022

Sole ProprietorNo

Medical School CMSClvlnd Clinic Lerner College Of Med Of Case Wstn Rsv UniversityGraduated 2015

Enumeration DateMay 19, 2015

Last NPPES UpdateFebruary 3, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2021

✔ NPI 1174902498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in OH · 35.135310

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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

315 E MAIN ST, Orwell, OH 44076

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephanus Eric Haryadi M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971832031

PECOS Enrollment IDI20190916000951

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 2

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

39 services30 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

20 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Metrohealth System

Acute Care Hospitals · Cleveland, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360059

Location2500 Metrohealth DriveCleveland, OH 44109 · Cuyahoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44076 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

90.9/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

81.8

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers22 claims59 services$5.48 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers11 claims11 services$111.52 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier19 claims19 services$15.98 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers16 claims16 services$42.93 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

1 supplier31 claims31 services$96.11 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 5

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

UNIVERSITY PRIMARY CARE PRACTICES INC

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