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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. AUGUSTINE JULIE PRODJINOTHO NP
NPI 1770233355
Nurse Practitioner - Family in Powell, OH

Active since March 25, 2022PECOS Enrolled
82.37/100
CMS Quality Rating
3207 STONERIDGE LN, POWELL, OH 43065(928) 503-6643 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Ms. Augustine Julie Prodjinotho Np NPPES

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

MS. AUGUSTINE JULIE PRODJINOTHO NP (NPI 1770233355) is an individual family provider in Powell, Ohio, licensed in Ohio (0043310) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770233355
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMS. AUGUSTINE JULIE PRODJINOTHOCredential: NP
Location Address3207 STONERIDGE LNPowell, OH 43065-3523
Mailing Address3207 Stoneridge LnPowell, OH 43065-3523 · (928) 503-6643
Phone(928) 503-6643
Sole ProprietorYes
Enumeration DateMarch 25, 2022
Last NPPES UpdateOctober 6, 2026
NPPES CertifiedOctober 6, 2026
✔ NPI 1770233355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · 0043310
3207 STONERIDGE LN, Powell, OH 43065
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Augustine Julie Prodjinotho Np 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Augustine Prodjinotho reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Signify Health, LLC
913 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Arizona enrollment
  • 556 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007
Nextcare Arizona LLC
1,657 mi
Urgent Care
914 N SCOTTSDALE RD STE 104
Tempe, AZ 85288
  • Reassigned Medicare billing, Arizona enrollment
  • 367 clinicians in this Medicare group
NPI 1043371826 (480) 924-8382

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

Areas of Expertise CMS Part B claims 5

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 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.
147 services145 patients
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.
93 services86 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
60 services60 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
28 services27 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43065 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
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.

82.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.57
Promoting Interoperability100
Improvement Activities40
Cost57.66

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 Augustine Prodjinotho's NPI number?

The NPI number for Augustine Prodjinotho is 1770233355. It was assigned to this individual provider in the NPPES registry on March 25, 2022.

Where is Augustine Prodjinotho located?

Augustine Prodjinotho practices at 3207 Stoneridge Ln, Powell, OH 43065. The listed phone number is (928) 503-6643.

What is Augustine Prodjinotho's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Augustine Prodjinotho enrolled in Medicare?

Yes. Augustine Prodjinotho is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Augustine Prodjinotho's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Augustine Prodjinotho reassigns Medicare benefits to 2 organizations: Signify Health, LLC (Dallas, TX) and Nextcare Arizona LLC (Tempe, AZ). 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 Augustine Prodjinotho's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Augustine Prodjinotho accept?

Health plans from Blue Cross Blue Shield of Arizona list Augustine Prodjinotho as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Augustine Prodjinotho was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days 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.