MISS MONICA TIRTARAHARDJA (PA-C) – Surgical Physician Assistant, NPI 1770117830
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,232 PHYSICIAN ASSISTANT in FL
Provider Addresses for MISS MONICA TIRTARAHARDJA (PA-C)
5503 S CONGRESS AVE STE 204
ATLANTIS, FL 334626626
Phone: (561) 410-5110
Fax: (561) 328-3911
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $291.
Total Amount is formed as General ($291) + Research ($0) + Ownership ($0) = $291.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Medical Device Business Services, Inc. ($139).
Total Amount
$291
General + Research + Ownership
Payments
7
Total payment records
General Amount
$291
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medical Device Business Services, Inc. | $139 |
| Medtronic, Inc. | $56 |
| Novartis Pharmaceuticals Corporation | $38 |
| UCB, Inc. | $37 |
| CSL Behring | $21 |
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: 2020-07-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200701002662 | I | Physician Assistant | FL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 22614 | Fusion of additional segment of spine | 57 | 16 | $0 |
Insurance plans in this area (ZIP 33462)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| N E U R O S U R G E R Y | FL |
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