NERISA IOLANI SOEHARTO PA-C
NPI 1770360588
Physician Assistant in Austin, TX

Q: What is Nerisa Soeharto's NPI number?

The NPI number for Nerisa Soeharto is 1770360588. It was assigned to this individual provider in the NPPES registry on September 14, 2023.

Q: What is Nerisa Soeharto's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nerisa Soeharto was last updated on April 9, 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.

Active since September 14, 2023PECOS EnrolledAccepts Medicare Assignment

3110 GUADALUPE ST STE 100, AUSTIN, TX 78705(512) 675-1359 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nerisa Iolani Soeharto Pa-c NPPES

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

NERISA IOLANI SOEHARTO PA-C (NPI 1770360588) is an individual physician assistant in Austin, Texas and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1770360588

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameNERISA IOLANI SOEHARTOCredential: PA-C

Location Address3110 GUADALUPE ST STE 100Austin, TX 78705-2858

Mailing Address3110 Guadalupe St Ste 100Austin, TX 78705-2858

Phone(512) 675-1359

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateSeptember 14, 2023

Last NPPES UpdateApril 9, 2024

NPPES CertifiedApril 9, 2024

✔ NPI 1770360588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3110 GUADALUPE ST STE 100, Austin, TX 78705

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Secondary Practice Locations 2

Location 12000 S I-35 Frontage Rd Suite N-5Round Rock, TX 78681 · Phone (512) 729-3138

Location 2709 E Slaughter Ln Ste 404Austin, TX 78744-2156 · Phone (512) 277-6643

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Nerisa Iolani Soeharto Pa-c 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 ID143678011

PECOS Enrollment IDI20231204000701

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 3

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.

26 services19 patients

Complete ultrasound scan of joint 76881

A complete ultrasound scan of a joint is a non-invasive procedure using sound waves to create images of your joint. It helps identify problems like inflammation, injury, or disease. It's painless, safe, and doesn't involve radiation.

24 services20 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.

17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78705 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

$89.03 typical visit price

range $57.88 – $174.00

Typical copayment $22.25 (range $14.47 – $43.50)

Most-billed visit code 99203

Established Patient

$71.95 typical visit price

range $18.88 – $142.23

Typical copayment $17.98 (range $4.72 – $35.55)

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 7

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

JOSHUA JOHN SIMPSON P.A.

Physician Assistant