MR. WIBISONO HARTOJO MD
NPI 1487883740
Internal Medicine in Falls Church, VA

Q: What is Wibisono Hartojo's NPI number?

The NPI number for Wibisono Hartojo is 1487883740. It was assigned to this individual provider in the NPPES registry on July 8, 2009.

Q: What is Wibisono Hartojo'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 Wibisono Hartojo was last updated on May 10, 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 July 08, 2009PECOS EnrolledAccepts Medicare Assignment

84.79/100

CMS Quality Rating

3300 GALLOWS RD, FALLS CHURCH, VA 22042(703) 776-4401(703) 776-7113 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 10, 2021, Jul 13, 2016 (2 updates tracked since 2016).

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About Mr. Wibisono Hartojo Md NPPES

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

MR. WIBISONO HARTOJO MD (NPI 1487883740) is an individual internal medicine provider in Falls Church, Virginia, licensed in Virginia (0101251159) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Inova Loudoun Hospital, and maintains a secondary practice location in Macon.

NPPES Registry Identity

NPI1487883740

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMR. WIBISONO HARTOJOCredential: MD

Location Address3300 GALLOWS RDFalls Church, VA 22042-3307

Mailing Address3300 Gallows RdFalls Church, VA 22042-3307 · (703) 776-4401 · Fax (703) 776-7113

Phone(703) 776-4401

Fax(703) 776-7113

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateJuly 8, 2009

Last NPPES UpdateMay 10, 20212 updates tracked since enumeration

NPPES CertifiedMay 10, 2021

✔ NPI 1487883740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in VA · 0101251159✔ Licensed in GA · 003711

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.

3300 GALLOWS RD, Falls Church, VA 22042

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Secondary Practice Location 1

Location 1777 Hemlock St, MSC #69Macon, GA 31201-2102 · Phone (478) 633-1700 · Fax (478) 633-7032

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

Mr. Wibisono Hartojo Md 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 ID5890950935

PECOS Enrollment IDI20120626000776

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 4

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

580 services536 patients

Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes 99236

This service involves a brief hospital stay for a serious health issue. Patients are admitted and discharged on the same day, typically within 55 minutes. It allows for close monitoring and immediate treatment, ensuring optimal care.

26 services26 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

22 services21 patients

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.

14 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Inova Loudoun Hospital

Acute Care Hospitals · Leesburg, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490043

Location44045 Riverside ParkwayLeesburg, VA 20176 · Loudoun County

Emergency services Birthing friendly

Inova Fairfax Hospital

Acute Care Hospitals · Falls Church, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490063

Location3300 Gallows RoadFalls Church, VA 22042 · Fairfax County

Emergency services Birthing friendly

Inova Mount Vernon Hospital

Acute Care Hospitals · Alexandria, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490122

Location2501 Parkers LaneAlexandria, VA 22306 · Fairfax County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22042 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

$147.85 typical visit price

range $65.18 – $194.86

Typical copayment $36.96 (range $16.29 – $48.71)

Most-billed visit code 99204

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

84.79/100

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

Individually scored

Quality

99.31

Improvement Activities

Cost

86.69

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.

ALLISON ELIZABETH TWEEDIE MD

Psychiatry & Neurology (Psychiatry)