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UTHA ANDHIKA LUMBANTOBING DNAP, CRNA
NPI 1629817028
Nurse Anesthetist, Certified Registered in Los Angeles, CA

Active since May 23, 2024Accepts Medicare Assignment
2051 MARENGO ST, LOS ANGELES, CA 90033(323) 409-7735 Get Directions Write a Review

NPPES record last updated: May 23, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Utha Andhika Lumbantobing Dnap, Crna NPPES

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

UTHA ANDHIKA LUMBANTOBING DNAP, CRNA (NPI 1629817028) is an individual nurse anesthetist, certified registered in Los Angeles, California, licensed in California (95002375) and active in the NPI registry since May 2024. He is a graduate of Other (2024).

NPPES Registry Identity

NPI1629817028
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameUTHA ANDHIKA LUMBANTOBINGCredential: DNAP, CRNA
Location Address2051 MARENGO STLos Angeles, CA 90033-1352
Mailing Address1764 N Encina AveRialto, CA 92376-2938 · (909) 996-9222
Phone(323) 409-7735
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMay 23, 2024
NPPES CertifiedMay 23, 2024
✔ NPI 1629817028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 95002375
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
2051 MARENGO ST, Los Angeles, CA 90033
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Utha Andhika Lumbantobing Dnap, Crna 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 ID9335660786
PECOS Enrollment IDI20250303000855

Medicare Billing Reassignments

4

Medicare enrollment records show Utha Lumbantobing reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Amsurg Arcadia Anesthesia LP
12 mi
Anesthesiology
488 EAST SANTA CLARA STREET, SUITE 102
Arcadia, CA 91006
  • Reassigned Medicare billing, California enrollment
  • 72 clinicians in this Medicare group
NPI 1114291226 (626) 359-9555
Inland Empire Anesthesia Medical Group, Inc
49 mi
Anesthesiology
400 N PEPPER AVE, DEPARTMENT OF ANESTHESIA
Colton, CA 92324
  • Reassigned Medicare billing, California enrollment
  • 48 clinicians in this Medicare group
NPI 1861502841 (909) 580-2440
Aria Anesthesia Group Inc
64 mi
Pain Medicine
18400 US HIGHWAY 18 STE B
Apple Valley, CA 92307
  • Reassigned Medicare billing, California enrollment
  • 30 clinicians in this Medicare group
NPI 1407124712 (949) 588-2190
Coachella Valley Anesthesia A Professional Corporation
103 mi
Anesthesiology
420 34TH ST
Bakersfield, CA 93301
  • Reassigned Medicare billing, California enrollment
  • 183 clinicians in this Medicare group
NPI 1013662048 (760) 538-5898

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90033 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
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
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. ISHAQUE ALI SYED M.D.
Internal Medicine
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-3147
CANDICE MARIE PALMISANO CNS
Clinical Nurse Specialist
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-8559
HAYLEY DAWN MORGAN
Respiratory Therapist, Registered
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-7928
COUNTY OF LOS ANGELES
Psychiatric Unit
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-2800
SIDNEY STEPHEN SORRELL MD
Student in an Organized Health Care Education/Training Program
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 442-1900
MR. PAUL ANDREW SCHMIDT
Respiratory Therapist, Registered (Neonatal/Pediatrics)
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-3281
ALDONIA ANTOINETTE WYLIE SENIOR RCP
Respiratory Therapist, Registered
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (562) 385-7687
MAXIMIANO VILLALPANDO NP
Nurse Practitioner (Acute Care)
2051 MARENGO ST
LOS ANGELES, CA 90033
Los Angeles County (323) 409-5637

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 Utha Lumbantobing's NPI number?

The NPI number for Utha Lumbantobing is 1629817028. It was assigned to this individual provider in the NPPES registry on May 23, 2024.

Where is Utha Lumbantobing located?

Utha Lumbantobing practices at 2051 Marengo St, Los Angeles, CA 90033. The listed phone number is (323) 409-7735.

What is Utha Lumbantobing's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Utha Lumbantobing enrolled in Medicare?

Yes. Utha Lumbantobing is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Utha Lumbantobing's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Utha Lumbantobing reassigns Medicare benefits to 4 organizations: Amsurg Arcadia Anesthesia LP (Arcadia, CA), Inland Empire Anesthesia Medical Group, Inc (Colton, CA), Aria Anesthesia Group Inc (Apple Valley, CA) and Coachella Valley Anesthesia A Professional Corporation (Bakersfield, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Utha Lumbantobing's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Utha Lumbantobing was last updated on May 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.