Philip Budihardjo (NPI# 1811198344, PAC ID# 3678623634) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1811198344 |
| PAC ID by PECOS | 3678623634 |
| Professional Enrollment ID | I20101101000456 |
| Full Name | Philip Budihardjo |
| Organization Legal Name | BELOIT RADIOLOGY LTD |
| Address |
1905 E Huebbe Pkwy Beloit WI 53511-1842 |
| Phone Number | 6083642302 |
| Gender | M |
| Medical School | KIRKSVILLE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 3274559711 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520100 | BELOIT HEALTH SYSTEM |
| 520098 | UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY |
| Address | Phone | Organization |
|---|---|---|
| 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 | 6083642302 | BELOIT RADIOLOGY LTD |
| 1969 W Hart Rd, Beloit, WI 53511-2230 | 6083645269 | BELOIT RADIOLOGY LTD |
| Organization Legal Name | BELOIT RADIOLOGY LTD |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas J Lisk | Diagnostic Radiology | Beloit Radiology Ltd | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| George Cherian | Diagnostic Radiology | Beloit Radiology Ltd | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Eric Joseph Goth | Diagnostic Radiology | Beloit Radiology Ltd | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Marlen F Junck | Diagnostic Radiology | Beloit Radiology Ltd | 1969 W Hart Rd, Beloit, WI 53511-2230 |
| Street Address |
1905 E HUEBBE PKWY |
| City | BELOIT |
| State | WI |
| Zip | 53511-1842 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sara A Jackson | Nurse Practitioner | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Madelene G Hamann | Nurse Practitioner | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Steven S Yang | Gastroenterology | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Cynthia L Philpott | Nurse Practitioner | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Yehia K Khoga | Psychiatry | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Joseph K Kittah | Pulmonary Disease | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Maria M Poplawska Goetzen | Family Medicine | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Thuy Thi Nguyen | Family Medicine | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Kristin K Lietzau | Physician Assistant | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Alan J Rehbein | Optometry | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Geoffrey T Bouc | Family Medicine | 3005 S Riverside Dr, Suite 101, Beloit, WI 53511-1500 | |
| Ann L Pruyne | Occupational Therapy | 828 E Azalea Ter, Beloit, WI 53511-1606 | |
| Frank C Kollins | Chiropractic | 1517 E Huebbe Pkwy, Beloit, WI 53511-1795 | |
| Deepak Kapoor | Internal Medicine | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Christel A Tecarro | Family Medicine | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Kevin M Tomera | Urology | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Cynthia L Palabrica | Obstetrics/gynecology | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Debasish Bhattacharyya | Neurology | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Annabelle Tolentino | Internal Medicine | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Michael M Korbol | Physician Assistant | Beloit Health System Inc | 1905 E Huebbe Pkwy, Beloit, WI 53511-1842 |
| Find all physicians in zip 53511 | |||
| City | BELOIT |
| Zip Code | 53511 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | BELOIT + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Philip Budihardjo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.