DR. VINCENTIUS JEREMY SUHARDI MD, PHD
NPI 1992265771
Student in an Organized Health Care Education/Training Program in New York, NY

Q: What is Vincentius Suhardi's NPI number?

The NPI number for Vincentius Suhardi is 1992265771. It was assigned to this individual provider in the NPPES registry on March 20, 2019.

Q: What is Vincentius Suhardi's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 20, 2019PECOS Enrolled

535 E 70TH ST, NEW YORK, NY 10021(212) 606-1000 Get Directions Write a Review

NPPES record last updated: May 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 30, 2025, Apr 26, 2021, Apr 15, 2021 and 1 more (4 updates tracked since 2019).

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About Dr. Vincentius Jeremy Suhardi Md, Phd NPPES

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

DR. VINCENTIUS JEREMY SUHARDI MD, PHD (NPI 1992265771) is an individual student in an organized health care education/training program in New York, New York and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992265771

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. VINCENTIUS JEREMY SUHARDICredential: MD, PHD

Location Address535 E 70TH STNew York, NY 10021-4823

Mailing Address535 E 70th StNew York, NY 10021-4898 · (857) 350-2072

Phone(212) 606-1000

Sole ProprietorYes

Enumeration DateMarch 20, 2019

Last NPPES UpdateMay 30, 20254 updates tracked since enumeration

NPPES CertifiedMay 30, 2025

✔ NPI 1992265771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

535 E 70TH ST, New York, NY 10021

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Vincentius Jeremy Suhardi Md, Phd 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.

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.

SARAH E. MCCORD PA-C

Physician Assistant (Surgical)