MR. INDRA SOERJA OETOMO (PT, LAC) – Acupuncturist, NPI 1326005745

MR. INDRA SOERJA OETOMO (PT, LAC) is a healthcare provider. based in Highlands ranch, Colorado. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, LAC. They hold a License No. 978 (CO). The NPI Number for MR. INDRA SOERJA OETOMO (PT, LAC) is 1326005745

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
MR. INDRA SOERJA OETOMO (PT, LAC)
NPI
1326005745
Phone
(303) 683-8338
Address
8955 S RIDGELINE BLVD
Enumeration Date
28 April 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3036838338
Graduation Year
1984 (42 years ago)
PAC ID
8224928460
Professional Enrollment ID
I20040614000456
Address ID
CO801292355HI8955XBLVD401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness85
Years active:20State licenses:2Digital endpointsOther names

2,988 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CO

Loading map...

Provider Addresses for MR. INDRA SOERJA OETOMO (PT, LAC)

  • Ski and Boot Lab, 8955, South Ridgeline Boulevard, Highlands Ranch, Douglas County, Colorado, 80129, United States

    SUITE 400

    HIGHLANDS RANCH, CO 801292362

    Phone: (303) 683-8338

    Fax: (303) 683-8809

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-06-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040614000456IPhysical Therapist In Private PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities1,20359$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care36234$0
97032Application of electrical stimulation with therapist present, each 15 minutes24736$0
97140Therapy procedure using manual technique, each 15 minutes16815$0
97161Evaluation for physical therapy, typically 20 minutes6455$0
View full utilization report →

Insurance plans in this area (ZIP 80129)

Loading plans...

Provider's Procedures

MR. INDRA SOERJA OETOMO (PT, LAC) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCO97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes97061

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does MR. INDRA SOERJA OETOMO (PT, LAC) have a public NPI I can cite?
Public records show MR. INDRA SOERJA OETOMO (PT, LAC) under NPI 1326005745.
Does the public listing show MR. INDRA SOERJA OETOMO (PT, LAC) as active?
MR. INDRA SOERJA OETOMO (PT, LAC)'s NPI record reflects an active status in NPPES.
How should patients interpret MR. INDRA SOERJA OETOMO (PT, LAC)'s specialty?
The extract shows Acupuncturist for MR. INDRA SOERJA OETOMO (PT, LAC). Clinical services aligned with this taxonomy classification.
What city is tied to MR. INDRA SOERJA OETOMO (PT, LAC)?
The directory associates MR. INDRA SOERJA OETOMO (PT, LAC) with Highlands Ranch, Colorado. Check all listed addresses for suites or satellite offices.
Why is information missing for MR. INDRA SOERJA OETOMO (PT, LAC)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

Similar Providers

8955 RIDGELINE BLVD STE 400
NPI: 1902983950
9370 S Colorado Blvd Unit A10
NPI: 1093875759
Highlands Ranch Optical, 9370, South Colorado Boulevard, Douglas County, Colorado, 80126, United States
NPI: 1295884278
Highlands Ranch Optical, 9370, South Colorado Boulevard, Douglas County, Colorado, 80126, United States
NPI: 1386802601
6881, South Holly Circle, Centennial, Arapahoe County, Colorado, 80112, United States
NPI: 1104058742
9370 S COLORADO BLVD UNIT A10
NPI: 1992031728
1379 PINERIDGE CT
NPI: 1831427103
9370 S COLORADO BLVD UNIT A10
NPI: 1316251564
850 VAN CLIBURN WAY
NPI: 1902185390